Provider Demographics
NPI:1508464611
Name:ERONSON, KRISTEN (BCBA)
Entity Type:Individual
Prefix:
First Name:KRISTEN
Middle Name:
Last Name:ERONSON
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:KRISTEN
Other - Middle Name:
Other - Last Name:FIELD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2645 N MAYFAIR RD STE 130
Mailing Address - Street 2:
Mailing Address - City:WAUWATOSA
Mailing Address - State:WI
Mailing Address - Zip Code:53226-1304
Mailing Address - Country:US
Mailing Address - Phone:414-256-0077
Mailing Address - Fax:
Practice Address - Street 1:2645 N MAYFAIR RD STE 130
Practice Address - Street 2:
Practice Address - City:WAUWATOSA
Practice Address - State:WI
Practice Address - Zip Code:53226-1304
Practice Address - Country:US
Practice Address - Phone:414-256-0077
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-12
Last Update Date:2023-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI393103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst