Provider Demographics
NPI:1902343486
Name:PARKER, DEBORAH MITCHELL (COTA/L)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:MITCHELL
Last Name:PARKER
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:DEBORAH
Other - Middle Name:LYNN
Other - Last Name:MITCHELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4220 4TH ST NW
Mailing Address - Street 2:WASHINGTON
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20011-4844
Mailing Address - Country:US
Mailing Address - Phone:202-487-3332
Mailing Address - Fax:
Practice Address - Street 1:7520 SURRATTS RD
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:MD
Practice Address - Zip Code:20735-3353
Practice Address - Country:US
Practice Address - Phone:301-856-1660
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-23
Last Update Date:2017-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDA02446224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant