Provider Demographics
NPI:1558631481
Name:PARENT, JANET MAYO (BCBA)
Entity Type:Individual
Prefix:MRS
First Name:JANET
Middle Name:MAYO
Last Name:PARENT
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 BLACK DOG LN
Mailing Address - Street 2:
Mailing Address - City:SOUTH BERWICK
Mailing Address - State:ME
Mailing Address - Zip Code:03908-1764
Mailing Address - Country:US
Mailing Address - Phone:207-807-5973
Mailing Address - Fax:
Practice Address - Street 1:12 BLACK DOG LN
Practice Address - Street 2:
Practice Address - City:SOUTH BERWICK
Practice Address - State:ME
Practice Address - Zip Code:03908-1764
Practice Address - Country:US
Practice Address - Phone:207-807-5973
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-10
Last Update Date:2012-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst