Provider Demographics
NPI:1548527609
Name:PARKER, PAMELA MARANAN (MED, LBA, BCBA)
Entity type:Individual
Prefix:MRS
First Name:PAMELA
Middle Name:MARANAN
Last Name:PARKER
Suffix:
Gender:F
Credentials:MED, LBA, BCBA
Other - Prefix:MRS
Other - First Name:PAMELA
Other - Middle Name:MARANAN
Other - Last Name:PARKER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MED, LBA, BCBA
Mailing Address - Street 1:8076 W SAHARA AVE STE B
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89117-7931
Mailing Address - Country:US
Mailing Address - Phone:702-829-8929
Mailing Address - Fax:702-829-8948
Practice Address - Street 1:8076 W SAHARA AVE STE B
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89117-7931
Practice Address - Country:US
Practice Address - Phone:702-829-8929
Practice Address - Fax:702-829-8948
Is Sole Proprietor?:No
Enumeration Date:2012-04-13
Last Update Date:2024-08-08
Deactivation Date:2018-05-02
Deactivation Code:
Reactivation Date:2018-11-28
Provider Licenses
StateLicense IDTaxonomies
NV1-20-42200103K00000X
103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst