Provider Demographics
NPI:1316565138
Name:PARNELL, STACY (RBT)
Entity Type:Individual
Prefix:
First Name:STACY
Middle Name:
Last Name:PARNELL
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 1:2904 E STAN SCHLUETER LOOP # 70
Mailing Address - Street 2:
Mailing Address - City:KILLEEN
Mailing Address - State:TX
Mailing Address - Zip Code:76542-4813
Mailing Address - Country:US
Mailing Address - Phone:254-294-4488
Mailing Address - Fax:512-367-5738
Practice Address - Street 1:2904 E STAN SCHLUETER LOOP # 70
Practice Address - Street 2:
Practice Address - City:KILLEEN
Practice Address - State:TX
Practice Address - Zip Code:76542-4813
Practice Address - Country:US
Practice Address - Phone:254-294-4488
Practice Address - Fax:512-367-5738
Is Sole Proprietor?:No
Enumeration Date:2020-07-08
Last Update Date:2020-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician