Provider Demographics
NPI:1184206997
Name:KREMER, ANJA KATHLEEN (BCBA)
Entity Type:Individual
Prefix:
First Name:ANJA
Middle Name:KATHLEEN
Last Name:KREMER
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 1:2 S STOLP AVE APT 306
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:IL
Mailing Address - Zip Code:60506-5398
Mailing Address - Country:US
Mailing Address - Phone:815-353-1711
Mailing Address - Fax:
Practice Address - Street 1:3S721 WEST AVE STE 400
Practice Address - Street 2:
Practice Address - City:WARRENVILLE
Practice Address - State:IL
Practice Address - Zip Code:60555-3261
Practice Address - Country:US
Practice Address - Phone:920-857-9041
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-22
Last Update Date:2021-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst