Provider Demographics
NPI:1689097172
Name:PARNELL, REBECCA (PSYD)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:PARNELL
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4733 W ATLANTIC AVE
Mailing Address - Street 2:SUITE 21
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33445-3706
Mailing Address - Country:US
Mailing Address - Phone:561-279-9295
Mailing Address - Fax:561-330-3423
Practice Address - Street 1:4733 W ATLANTIC AVE
Practice Address - Street 2:SUITE 21
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33445-3706
Practice Address - Country:US
Practice Address - Phone:561-279-9295
Practice Address - Fax:561-330-3423
Is Sole Proprietor?:No
Enumeration Date:2014-02-04
Last Update Date:2014-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY8893103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical