Provider Demographics
NPI:1750823977
Name:PARKIN, JILL (BCBA)
Entity Type:Individual
Prefix:
First Name:JILL
Middle Name:
Last Name:PARKIN
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 1:1723 MAIZE BEND DR
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78727-3434
Mailing Address - Country:US
Mailing Address - Phone:617-840-6241
Mailing Address - Fax:
Practice Address - Street 1:5209 DUVAL RD
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78727-6614
Practice Address - Country:US
Practice Address - Phone:512-423-3225
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-07
Last Update Date:2016-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1-02-0835103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst