Provider Demographics
NPI:1558991638
Name:PARKMAN, SHELBY ANN (MED, BCBA)
Entity Type:Individual
Prefix:
First Name:SHELBY
Middle Name:ANN
Last Name:PARKMAN
Suffix:
Gender:F
Credentials:MED, BCBA
Other - Prefix:
Other - First Name:SHELBY
Other - Middle Name:ANN
Other - Last Name:METZLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BCBA
Mailing Address - Street 1:3500 DEPAUW BLVD STE 3070
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46268-6135
Mailing Address - Country:US
Mailing Address - Phone:855-324-0885
Mailing Address - Fax:317-520-8200
Practice Address - Street 1:7000 LAKE ELLENOR DR
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32809-5749
Practice Address - Country:US
Practice Address - Phone:321-655-6585
Practice Address - Fax:317-520-8200
Is Sole Proprietor?:No
Enumeration Date:2020-01-17
Last Update Date:2022-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL103K00000X
106S00000X
FL1-20-45096103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician