Provider Demographics
NPI:1558862664
Name:PARRISH, JENNIFER LYNN (OTR, LCSW)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:LYNN
Last Name:PARRISH
Suffix:
Gender:F
Credentials:OTR, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4028 RIVE LN
Mailing Address - Street 2:
Mailing Address - City:ADDISON
Mailing Address - State:TX
Mailing Address - Zip Code:75001-3121
Mailing Address - Country:US
Mailing Address - Phone:713-306-9355
Mailing Address - Fax:
Practice Address - Street 1:9101 BURNET RD STE 103
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78758-5260
Practice Address - Country:US
Practice Address - Phone:512-248-2422
Practice Address - Fax:512-248-2354
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-23
Last Update Date:2019-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX118155225XP0200X, 225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics