Provider Demographics
NPI:1932422664
Name:PARKS, CRISTINA (COTA/L)
Entity Type:Individual
Prefix:
First Name:CRISTINA
Middle Name:
Last Name:PARKS
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:CRISTINA
Other - Middle Name:
Other - Last Name:JIMENEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:10270 E ESSEX VILLAGE DR
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85748-2101
Mailing Address - Country:US
Mailing Address - Phone:520-722-1729
Mailing Address - Fax:
Practice Address - Street 1:10270 E ESSEX VILLAGE DR
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85748-2101
Practice Address - Country:US
Practice Address - Phone:520-722-1729
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-03-09
Last Update Date:2010-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ2703224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant