Provider Demographics
NPI:1508225657
Name:ST. GERMAINE, KIRSTEN (BCBA)
Entity Type:Individual
Prefix:
First Name:KIRSTEN
Middle Name:
Last Name:ST. GERMAINE
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:KIRSTEN
Other - Middle Name:
Other - Last Name:BERGSTRAND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:14131 MIDWAY RD STE 800
Mailing Address - Street 2:
Mailing Address - City:ADDISON
Mailing Address - State:TX
Mailing Address - Zip Code:75001-3627
Mailing Address - Country:US
Mailing Address - Phone:972-895-3287
Mailing Address - Fax:469-914-7903
Practice Address - Street 1:930 WALL ST
Practice Address - Street 2:
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73069-6319
Practice Address - Country:US
Practice Address - Phone:405-384-8588
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-02-17
Last Update Date:2020-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst