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General NPI Number Information
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NPI Number | 1982245106
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Entity Type | Individual
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Provider Name | JESSICA LYNN PARKER BCBA
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Gender | Female
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Dates
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Enumeration Date | 09/30/2019
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Last Update Date | 01/28/2025
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Provider Practice Location Address
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Address Line | 6740 ROCK SPRING RD
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City | WILMINGTON
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State | NC
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Zip | 28405-3185
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Country | US
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Telephone | 910-619-6500
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Fax |
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Provider Business Mailing Address
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Address Line | 112 ACADIAN LOOP APT 301
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City | HAMPSTEAD
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State | NC
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Zip | 28443-0170
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Country | US
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Telephone | 910-833-2682
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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 | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number | RBT-19-90221
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License Number State | MO
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Taxonomy #3
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 2104
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License Number State | NC
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Taxonomy #4
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Taxonomy Code | 2080P0006X
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Taxonomy Name | Developmental - Behavioral Pediatrics Physician
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License Number | 0-23-14270
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License Number State | NC
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