Provider Demographics
NPI:1053857714
Name:YURGA, KRISTA (BCBA)
Entity Type:Individual
Prefix:
First Name:KRISTA
Middle Name:
Last Name:YURGA
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:KRISTA
Other - Middle Name:
Other - Last Name:SIEGERT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:BCBA
Mailing Address - Street 1:605 WITBECK DR
Mailing Address - Street 2:
Mailing Address - City:CLARE
Mailing Address - State:MI
Mailing Address - Zip Code:48617-9723
Mailing Address - Country:US
Mailing Address - Phone:989-240-0619
Mailing Address - Fax:
Practice Address - Street 1:6820 SNOWBIRD DR
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80918-1306
Practice Address - Country:US
Practice Address - Phone:989-240-0619
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-18
Last Update Date:2023-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1-17-26456103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst