Provider Demographics
NPI:1568850956
Name:DEERY, KRISTEN (BCBA, BSL)
Entity Type:Individual
Prefix:MRS
First Name:KRISTEN
Middle Name:
Last Name:DEERY
Suffix:
Gender:F
Credentials:BCBA, BSL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 COUNTRY RD
Mailing Address - Street 2:
Mailing Address - City:PERKASIE
Mailing Address - State:PA
Mailing Address - Zip Code:18944-5401
Mailing Address - Country:US
Mailing Address - Phone:267-210-5525
Mailing Address - Fax:
Practice Address - Street 1:16 COUNTRY RD
Practice Address - Street 2:
Practice Address - City:PERKASIE
Practice Address - State:PA
Practice Address - Zip Code:18944-5401
Practice Address - Country:US
Practice Address - Phone:267-210-5525
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-01-07
Last Update Date:2015-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PABH002560103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst