Provider Demographics
NPI:1235581679
Name:PARKER, TIFFANY (RBT)
Entity Type:Individual
Prefix:MS
First Name:TIFFANY
Middle Name:
Last Name:PARKER
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3950 GLEN VERDE TRL APT 303
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27613-4250
Mailing Address - Country:US
Mailing Address - Phone:845-421-0788
Mailing Address - Fax:
Practice Address - Street 1:3950 GLEN VERDE TRL APT 303
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27613-4250
Practice Address - Country:US
Practice Address - Phone:845-421-0788
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-11
Last Update Date:2020-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCRBT-20-138616106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician