Provider Demographics
NPI:1871943688
Name:PARISI, MICHELE (BCBA)
Entity type:Individual
Prefix:
First Name:MICHELE
Middle Name:
Last Name:PARISI
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:MRS
Other - First Name:MICHELE
Other - Middle Name:P
Other - Last Name:LEE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:601 KIMBERLY CT
Mailing Address - Street 2:
Mailing Address - City:FORKED RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08731-4963
Mailing Address - Country:US
Mailing Address - Phone:609-276-1864
Mailing Address - Fax:
Practice Address - Street 1:601 KIMBERLY CT
Practice Address - Street 2:
Practice Address - City:FORKED RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08731-4963
Practice Address - Country:US
Practice Address - Phone:609-276-1864
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-13
Last Update Date:2022-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ1-14-9717103K00000X
103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1457089484OtherGROUP NPI