Provider Demographics
NPI:1801225859
Name:PARRISH, ANGELA JM (BS, BCABA)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:JM
Last Name:PARRISH
Suffix:
Gender:F
Credentials:BS, BCABA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10716 MCGAHAN DR
Mailing Address - Street 2:
Mailing Address - City:FOUNTAIN
Mailing Address - State:CO
Mailing Address - Zip Code:80817-6314
Mailing Address - Country:US
Mailing Address - Phone:719-344-8015
Mailing Address - Fax:
Practice Address - Street 1:3361 N ACADEMY BLVD
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80917-5103
Practice Address - Country:US
Practice Address - Phone:719-465-3989
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-11-09
Last Update Date:2013-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst