Provider Demographics
NPI:1609267798
Name:HARDIN, KRISTYN (MS, BCBA, LBA)
Entity Type:Individual
Prefix:
First Name:KRISTYN
Middle Name:
Last Name:HARDIN
Suffix:
Gender:F
Credentials:MS, BCBA, LBA
Other - Prefix:
Other - First Name:KRISTYN
Other - Middle Name:
Other - Last Name:HARDIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:BCBA
Mailing Address - Street 1:3958 HARDIN ELLISON RD
Mailing Address - Street 2:
Mailing Address - City:FRANKLINVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27248-8112
Mailing Address - Country:US
Mailing Address - Phone:336-953-3812
Mailing Address - Fax:
Practice Address - Street 1:3958 HARDIN ELLISON RD
Practice Address - Street 2:
Practice Address - City:FRANKLINVILLE
Practice Address - State:NC
Practice Address - Zip Code:27248
Practice Address - Country:US
Practice Address - Phone:336-953-3812
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-02-10
Last Update Date:2022-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1-18-29881103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst