Provider Demographics
NPI:1720633233
Name:KRIEGER, SHIRLEY L (MA, BCBA)
Entity type:Individual
Prefix:
First Name:SHIRLEY
Middle Name:L
Last Name:KRIEGER
Suffix:
Gender:F
Credentials:MA, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:356 MCLAWS CIR STE 2
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:23185-6345
Mailing Address - Country:US
Mailing Address - Phone:757-849-8170
Mailing Address - Fax:757-706-3550
Practice Address - Street 1:356 MCLAWS CIR STE 2
Practice Address - Street 2:
Practice Address - City:WILLIAMSBURG
Practice Address - State:VA
Practice Address - Zip Code:23185-6345
Practice Address - Country:US
Practice Address - Phone:757-849-8170
Practice Address - Fax:757-706-3550
Is Sole Proprietor?:No
Enumeration Date:2019-08-02
Last Update Date:2019-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0133001477103K00000X
VA103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA14534142OtherCAQH