Provider Demographics
NPI:1023629763
Name:PARKER, KRISTY MOODY (OTR/L)
Entity type:Individual
Prefix:
First Name:KRISTY
Middle Name:MOODY
Last Name:PARKER
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:840 KENNEDY MEMORIAL DR
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04963-4887
Mailing Address - Country:US
Mailing Address - Phone:207-716-1863
Mailing Address - Fax:207-716-4002
Practice Address - Street 1:840 KENNEDY MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:ME
Practice Address - Zip Code:04963-4887
Practice Address - Country:US
Practice Address - Phone:207-716-1863
Practice Address - Fax:207-716-4002
Is Sole Proprietor?:No
Enumeration Date:2020-08-16
Last Update Date:2025-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEOT3905225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics