Provider Demographics
NPI:1619444999
Name:PARKER, KELCEY ANN (RBT)
Entity Type:Individual
Prefix:
First Name:KELCEY
Middle Name:ANN
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 1:12303 KINGS GARDEN CT
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77044-5696
Mailing Address - Country:US
Mailing Address - Phone:281-435-9448
Mailing Address - Fax:
Practice Address - Street 1:2825 W TOWN CENTER CIR
Practice Address - Street 2:
Practice Address - City:KINGWOOD
Practice Address - State:TX
Practice Address - Zip Code:77339-3734
Practice Address - Country:US
Practice Address - Phone:281-570-2420
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-25
Last Update Date:2018-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX22066319106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician