Healthcare Provider Details

I. General information

NPI: 1487928479
Provider Name (Legal Business Name): CLARA PARNELL OTR/L
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/08/2012
Last Update Date: 03/27/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3100 LORNA RD SUITE 305
BIRMINGHAM AL
35216-5453
US

IV. Provider business mailing address

3100 LORNA RD SUITE 305
BIRMINGHAM AL
35216-5453
US

V. Phone/Fax

Practice location:
  • Phone: 205-979-7004
  • Fax:
Mailing address:
  • Phone: 205-979-7004
  • Fax: 205-979-7004

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number0435
License Number StateAL
# 2
Primary TaxonomyN
Taxonomy Code225XE0001X
TaxonomyEnvironmental Modification Occupational Therapist
License Number0435
License Number StateAL
# 3
Primary TaxonomyN
Taxonomy Code225XL0004X
TaxonomyLow Vision Occupational Therapist
License Number0435
License Number StateAL

VIII. Authorized Official

Name: CLARA W PARNELL
Title or Position: OWNER
Credential: OTR/L, MS,CAPS
Phone: 205-516-3250