Provider Demographics
NPI:1306337084
Name:HOWARD, KRISTIN LAURYN (BCBA)
Entity type:Individual
Prefix:
First Name:KRISTIN
Middle Name:LAURYN
Last Name:HOWARD
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 STEELE ST APT 1102
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80206-5266
Mailing Address - Country:US
Mailing Address - Phone:504-339-7555
Mailing Address - Fax:
Practice Address - Street 1:100 STEELE ST APT 1102
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80206-5266
Practice Address - Country:US
Practice Address - Phone:504-339-7555
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-29
Last Update Date:2018-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1-15-20638103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst