Provider Demographics
NPI:1760033625
Name:PARISE, COLLEEN (BCBA)
Entity Type:Individual
Prefix:
First Name:COLLEEN
Middle Name:
Last Name:PARISE
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:COLLEEN
Other - Middle Name:
Other - Last Name:DRENTH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:36 N PROSPECT STREET EXT
Mailing Address - Street 2:
Mailing Address - City:ANSONIA
Mailing Address - State:CT
Mailing Address - Zip Code:06401-3023
Mailing Address - Country:US
Mailing Address - Phone:203-930-0025
Mailing Address - Fax:
Practice Address - Street 1:36 N PROSPECT STREET EXT
Practice Address - Street 2:
Practice Address - City:ANSONIA
Practice Address - State:CT
Practice Address - Zip Code:06401-3023
Practice Address - Country:US
Practice Address - Phone:203-930-0025
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-23
Last Update Date:2019-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty