Provider Demographics
NPI:1710582721
Name:PARKER, AMBER (BCBA)
Entity type:Individual
Prefix:
First Name:AMBER
Middle Name:
Last Name:PARKER
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9023 COPELAND RD
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33637-5101
Mailing Address - Country:US
Mailing Address - Phone:813-407-1092
Mailing Address - Fax:
Practice Address - Street 1:9023 COPELAND RD
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33637-5101
Practice Address - Country:US
Practice Address - Phone:813-407-1092
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-30
Last Update Date:2024-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1-21-55228103K00000X
CO12155228103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst