Provider Demographics
NPI:1134691132
Name:PARRA, GLORIA DEL PILAR (RBT)
Entity type:Individual
Prefix:
First Name:GLORIA
Middle Name:DEL PILAR
Last Name:PARRA
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5863 S RUE RD
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33415-7151
Mailing Address - Country:US
Mailing Address - Phone:561-301-7143
Mailing Address - Fax:
Practice Address - Street 1:7711 N MILITARY TRL STE 1008
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33410-6506
Practice Address - Country:US
Practice Address - Phone:561-480-1075
Practice Address - Fax:561-584-5836
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-02
Last Update Date:2022-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL102586000Medicaid
RBT-19-80276OtherBACB