Provider Demographics
NPI:1730923830
Name:PARKINSON, DEIRDRE (BCBA, LBS)
Entity type:Individual
Prefix:
First Name:DEIRDRE
Middle Name:
Last Name:PARKINSON
Suffix:
Gender:F
Credentials:BCBA, LBS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:528 SEVEN BRIDGE RD UNIT 246
Mailing Address - Street 2:
Mailing Address - City:EAST STROUDSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:18301-7621
Mailing Address - Country:US
Mailing Address - Phone:267-684-9366
Mailing Address - Fax:
Practice Address - Street 1:528 SEVEN BRIDGE RD UNIT 246
Practice Address - Street 2:
Practice Address - City:EAST STROUDSBURG
Practice Address - State:PA
Practice Address - Zip Code:18301-7621
Practice Address - Country:US
Practice Address - Phone:267-684-9366
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-24
Last Update Date:2024-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PABH005931103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst