Provider Demographics
NPI:1316373657
Name:MYERS, KRITSA (MS, BCBA)
Entity Type:Individual
Prefix:MS
First Name:KRITSA
Middle Name:
Last Name:MYERS
Suffix:
Gender:F
Credentials:MS, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 41
Mailing Address - Street 2:
Mailing Address - City:SWAMPSCOTT
Mailing Address - State:MA
Mailing Address - Zip Code:01907-0041
Mailing Address - Country:US
Mailing Address - Phone:978-317-8378
Mailing Address - Fax:866-222-3565
Practice Address - Street 1:160 WINDSOR AVE
Practice Address - Street 2:
Practice Address - City:SWAMPSCOTT
Practice Address - State:MA
Practice Address - Zip Code:01907-1048
Practice Address - Country:US
Practice Address - Phone:978-317-8378
Practice Address - Fax:866-222-3565
Is Sole Proprietor?:No
Enumeration Date:2013-09-18
Last Update Date:2013-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1-12-12631103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst