Provider Demographics
NPI:1922693647
Name:PARR, CARLYN SUSANNE (BS, BCABA, LABA)
Entity Type:Individual
Prefix:MS
First Name:CARLYN
Middle Name:SUSANNE
Last Name:PARR
Suffix:
Gender:F
Credentials:BS, BCABA, LABA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10800 MIDLOTHIAN TPKE STE 100
Mailing Address - Street 2:
Mailing Address - City:NORTH CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23235-4700
Mailing Address - Country:US
Mailing Address - Phone:804-370-6302
Mailing Address - Fax:
Practice Address - Street 1:8040 VILLA PARK DR STE 100
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23228-6507
Practice Address - Country:US
Practice Address - Phone:804-897-1753
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-04
Last Update Date:2021-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst