Provider Demographics
NPI:1558091538
Name:NEGRON, KRISTINA ISABEL (BCBA)
Entity Type:Individual
Prefix:MS
First Name:KRISTINA
Middle Name:ISABEL
Last Name:NEGRON
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 1:377 VALLEY RD UNIT 2712
Mailing Address - Street 2:
Mailing Address - City:CLIFTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07013-1319
Mailing Address - Country:US
Mailing Address - Phone:201-731-2842
Mailing Address - Fax:
Practice Address - Street 1:377 VALLEY RD UNIT 2712
Practice Address - Street 2:
Practice Address - City:CLIFTON
Practice Address - State:NJ
Practice Address - Zip Code:07013-1319
Practice Address - Country:US
Practice Address - Phone:201-731-2842
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-13
Last Update Date:2022-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty