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General NPI Number Information
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NPI Number | 1417763319
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Entity Type | Individual
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Provider Name | RYLIE JANE PARKER
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Gender | Female
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Dates
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Enumeration Date | 12/05/2024
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Last Update Date | 12/05/2024
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Provider Practice Location Address
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Address Line | 3919 W WACO DR
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City | WACO
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State | TX
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Zip | 76710-7107
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Country | US
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Telephone | 512-334-9907
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Fax |
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Provider Business Mailing Address
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Address Line | 23 OLEANDER ST
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City | WACO
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State | TX
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Zip | 76708-9635
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Country | US
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Telephone | 254-723-9441
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number |
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License Number State | TX
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