Provider Demographics
NPI:1568012821
Name:TYLER, KRISTEN (MS, BCBA, LBA)
Entity type:Individual
Prefix:
First Name:KRISTEN
Middle Name:
Last Name:TYLER
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 1:110 11TH ST N
Mailing Address - Street 2:
Mailing Address - City:SAUK RAPIDS
Mailing Address - State:MN
Mailing Address - Zip Code:56379-2123
Mailing Address - Country:US
Mailing Address - Phone:218-242-3782
Mailing Address - Fax:
Practice Address - Street 1:110 11TH ST N
Practice Address - Street 2:
Practice Address - City:SAUK RAPIDS
Practice Address - State:MN
Practice Address - Zip Code:56379-2123
Practice Address - Country:US
Practice Address - Phone:218-242-3782
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-18
Last Update Date:2024-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1903103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst