Krystle Anderson, MA, BCBA

Individual provider Active NPI Behavior Analyst · Creve Coeur, MO

NPI 1124363544 · NPPES record last updated Oct 22, 2019

Key facts

NPI
1124363544
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Analyst 103K00000X
License
2012039557 (MO)
Practice address
650 Office Pkwy
Creve Coeur, MO 63141-7103
Phone
(314) 486-2311
NPI assigned
Dec 11, 2012
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
2012039557MOMDBehavioral Analyst

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X 2012039557 MO Yes

Addresses

Primary practice location

650 Office Pkwy
Creve Coeur, MO 63141-7103

Mailing address

8710 Eulalie Ave
Brentwood, MO 63144-2012
Phone (314) 486-2311

Other practice location 1

8710 Eulalie Ave
Brentwood, MO 63144-2012
Phone (314) 486-2311

Other providers in Creve Coeur, MO

All providers in Creve Coeur, MO · Behavior Analyst in Missouri

Sources for this page

Verify at the official NPI Registry.