Provider Demographics
NPI:1508206392
Name:KRENZ, CHLOE LOUISE
Entity Type:Individual
Prefix:MISS
First Name:CHLOE
Middle Name:LOUISE
Last Name:KRENZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3015 SW AVALON WAY APT 101
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98126-4444
Mailing Address - Country:US
Mailing Address - Phone:561-502-7937
Mailing Address - Fax:
Practice Address - Street 1:3015 SW AVALON WAY APT 101
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98126-4444
Practice Address - Country:US
Practice Address - Phone:561-502-7937
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-26
Last Update Date:2019-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
247200000X
WABA60824841103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other