Healthcare Provider Details

I. General information

NPI: 1164196812
Provider Name (Legal Business Name): ELLEN PARKER BCABA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ELLEN RATLIFF

II. Dates (important events)

Enumeration Date: 08/05/2021
Last Update Date: 07/12/2026
Certification Date: 07/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3812 GALLAGHER RD
PLANT CITY FL
33565-4812
US

IV. Provider business mailing address

3812 GALLAGHER RD
PLANT CITY FL
33565-4812
US

V. Phone/Fax

Practice location:
  • Phone: 813-598-6527
  • Fax:
Mailing address:
  • Phone: 813-598-6527
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: