Individual
ELLEN PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA, LBA
Contact information
Practice address
4235 S STREAM BLVD STE 300, CHARLOTTE, NC 28217-0143
(980) 785-1113
Mailing address
410 DRAGONFLY TRL, CHAPEL HILL, NC 27517-9503
(224) 522-9790
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
NC
Other
Enumeration date
12/16/2020
Last updated
12/02/2025
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