Provider Demographics
NPI:1508095704
Name:FOLEY, KRISTIN NANCY (BCBA)
Entity Type:Individual
Prefix:
First Name:KRISTIN
Middle Name:NANCY
Last Name:FOLEY
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 1:51 FIERRO AVE
Mailing Address - Street 2:
Mailing Address - City:MATAWAN
Mailing Address - State:NJ
Mailing Address - Zip Code:07747-3038
Mailing Address - Country:US
Mailing Address - Phone:732-788-5850
Mailing Address - Fax:708-801-7211
Practice Address - Street 1:51 FIERRO AVE
Practice Address - Street 2:
Practice Address - City:MATAWAN
Practice Address - State:NJ
Practice Address - Zip Code:07747-3038
Practice Address - Country:US
Practice Address - Phone:732-788-5850
Practice Address - Fax:708-801-7211
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-09
Last Update Date:2014-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ1-08-4076103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst