Provider Demographics
NPI:1588819304
Name:PARRISH, REBECCA A (MS, BCABA)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:A
Last Name:PARRISH
Suffix:
Gender:F
Credentials:MS, BCABA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16515 DEER CHASE LOOP
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32828-6935
Mailing Address - Country:US
Mailing Address - Phone:407-697-0140
Mailing Address - Fax:
Practice Address - Street 1:1525 S ALAFAYA TRL STE 101
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32828-8926
Practice Address - Country:US
Practice Address - Phone:407-382-5551
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-20
Last Update Date:2008-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL0-07-2335103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst