Provider Demographics
NPI:1609532662
Name:GREGORY, KRISTA ANN (RBT)
Entity Type:Individual
Prefix:
First Name:KRISTA
Middle Name:ANN
Last Name:GREGORY
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:131 HATCHER LN STE A
Mailing Address - Street 2:
Mailing Address - City:CLARKSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37043-5921
Mailing Address - Country:US
Mailing Address - Phone:931-444-1449
Mailing Address - Fax:931-919-1207
Practice Address - Street 1:131 HATCHER LN STE A
Practice Address - Street 2:
Practice Address - City:CLARKSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37043-5921
Practice Address - Country:US
Practice Address - Phone:931-444-1449
Practice Address - Fax:931-919-1207
Is Sole Proprietor?:No
Enumeration Date:2021-11-15
Last Update Date:2023-07-31
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician