Provider Demographics
NPI:1003421058
Name:PARKER, KAITLYN (BCBA, LBA)
Entity Type:Individual
Prefix:
First Name:KAITLYN
Middle Name:
Last Name:PARKER
Suffix:
Gender:F
Credentials:BCBA, LBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4819 IHLES RD
Mailing Address - Street 2:
Mailing Address - City:LAKE CHARLES
Mailing Address - State:LA
Mailing Address - Zip Code:70605-5900
Mailing Address - Country:US
Mailing Address - Phone:337-602-6247
Mailing Address - Fax:
Practice Address - Street 1:4819 IHLES RD
Practice Address - Street 2:
Practice Address - City:LAKE CHARLES
Practice Address - State:LA
Practice Address - Zip Code:70605-5900
Practice Address - Country:US
Practice Address - Phone:337-602-6247
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-15
Last Update Date:2021-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst