Provider Demographics
NPI:1144664004
Name:PARKER, LAURA (LMT)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:PARKER
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:228 FRANKLIN ST # 116
Mailing Address - Street 2:
Mailing Address - City:DELAWARE CITY
Mailing Address - State:DE
Mailing Address - Zip Code:19706-8732
Mailing Address - Country:US
Mailing Address - Phone:302-668-4861
Mailing Address - Fax:
Practice Address - Street 1:228 FRANKLIN ST # 116
Practice Address - Street 2:
Practice Address - City:DELAWARE CITY
Practice Address - State:DE
Practice Address - Zip Code:19706-8732
Practice Address - Country:US
Practice Address - Phone:302-668-4861
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-23
Last Update Date:2013-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEMT-0003556225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist