Provider Demographics
NPI:1083459457
Name:TERREZZA, KRISTEN FRANCES (MA, BCBA, LBA)
Entity type:Individual
Prefix:MRS
First Name:KRISTEN
Middle Name:FRANCES
Last Name:TERREZZA
Suffix:
Gender:F
Credentials:MA, BCBA, LBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:FAMILY OF KIDZ
Mailing Address - Street 2:1400 OLD COUNTRY ROAD, SUITE C103N
Mailing Address - City:WESTBURY
Mailing Address - State:NY
Mailing Address - Zip Code:11590
Mailing Address - Country:US
Mailing Address - Phone:718-614-5570
Mailing Address - Fax:
Practice Address - Street 1:1420 157TH ST
Practice Address - Street 2:
Practice Address - City:WHITESTONE
Practice Address - State:NY
Practice Address - Zip Code:11357-2717
Practice Address - Country:US
Practice Address - Phone:718-614-5570
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-27
Last Update Date:2024-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY003474103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst