Provider Demographics
NPI:1487794699
Name:SCHRANK-KRUPA, CHRISTIE LYN (MS, BCBA, LBA)
Entity type:Individual
Prefix:
First Name:CHRISTIE
Middle Name:LYN
Last Name:SCHRANK-KRUPA
Suffix:
Gender:F
Credentials:MS, BCBA, LBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:491 DARYL DR
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:NY
Mailing Address - Zip Code:11763-1226
Mailing Address - Country:US
Mailing Address - Phone:631-220-2512
Mailing Address - Fax:
Practice Address - Street 1:491 DARYL DR
Practice Address - Street 2:
Practice Address - City:MEDFORD
Practice Address - State:NY
Practice Address - Zip Code:11763-1226
Practice Address - Country:US
Practice Address - Phone:631-220-2512
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-07
Last Update Date:2016-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY103TS0200X
NY000378103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst