Provider Demographics
NPI:1104058536
Name:PARISH, JOEL SCOTT (BCBA)
Entity type:Individual
Prefix:MR
First Name:JOEL
Middle Name:SCOTT
Last Name:PARISH
Suffix:
Gender:M
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50300 REBECCA DR
Mailing Address - Street 2:
Mailing Address - City:PAW PAW
Mailing Address - State:MI
Mailing Address - Zip Code:49079-8432
Mailing Address - Country:US
Mailing Address - Phone:269-655-4393
Mailing Address - Fax:
Practice Address - Street 1:50300 REBECCA DR
Practice Address - Street 2:
Practice Address - City:PAW PAW
Practice Address - State:MI
Practice Address - Zip Code:49079-8432
Practice Address - Country:US
Practice Address - Phone:269-655-4393
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-18
Last Update Date:2009-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI1-06-2697103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst