MEDICARE: RONIESHA NICOL PARISH M. ED.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TB0200X	Cognitive & Behavioral Psychologist
2	103TM1800X	Intellectual & Developmental Disabilities Psychologist

General Provider Information

NPI Number	:	1184962748
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RONIESHA NICOL PARISH M. ED.

Provider Business Mailing Address
First Line	:	9018 TRIOLA LN
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77036-6148
Country	:	US
Telephone Number	:	713-702-9188
Fax Number	:

Provider Business Practice Location Address
First Line	:	9018 TRIOLA LN
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77036-6148
Country	:	US
Telephone Number	:	713-702-9188
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/16/2013
Last Update Date	:	01/16/2013

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