Provider Demographics
NPI:1215437975
Name:WOO, KRISTI (RBT)
Entity type:Individual
Prefix:
First Name:KRISTI
Middle Name:
Last Name:WOO
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:KRISTI
Other - Middle Name:
Other - Last Name:PICKETT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:618 N HIGH SCHOOL RD
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46214-3684
Mailing Address - Country:US
Mailing Address - Phone:317-731-7777
Mailing Address - Fax:
Practice Address - Street 1:618 N HIGH SCHOOL RD
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46214-3684
Practice Address - Country:US
Practice Address - Phone:317-731-7777
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-19
Last Update Date:2024-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106S00000X
IN0-24-15164106E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician