Healthcare Provider Details

I. General information

NPI: 1396649406
Provider Name (Legal Business Name): DYVION PARSONS
Entity Type: Individual
Gender:
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/05/2026
Last Update Date: 10/05/2026
Certification Date: 10/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5915 S EMERSON AVE STE 100
INDIANAPOLIS IN
46237-1972
US

IV. Provider business mailing address

5134 RUM CHERRY WAY
INDIANAPOLIS IN
46237-3861
US

V. Phone/Fax

Practice location:
  • Phone: 317-661-1060
  • Fax:
Mailing address:
  • Phone: 317-980-6203
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number9370999384
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: