Provider Demographics
NPI:1649560715
Name:DELORENZO, CHRISTIN (MSED, BCBA)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTIN
Middle Name:
Last Name:DELORENZO
Suffix:
Gender:F
Credentials:MSED, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:171 99TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11209-7937
Mailing Address - Country:US
Mailing Address - Phone:347-585-5855
Mailing Address - Fax:
Practice Address - Street 1:171 99TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11209-7937
Practice Address - Country:US
Practice Address - Phone:347-585-5855
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-11
Last Update Date:2011-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1-04-1600103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst