Provider Demographics
NPI:1790416121
Name:NERIO, KRISTEN GRACE (BCBA)
Entity Type:Individual
Prefix:MS
First Name:KRISTEN
Middle Name:GRACE
Last Name:NERIO
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:MS
Other - First Name:KRISTEN
Other - Middle Name:GRACE
Other - Last Name:FARMER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CBT
Mailing Address - Street 1:4606 108TH ST SW
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98499-4146
Mailing Address - Country:US
Mailing Address - Phone:253-693-2626
Mailing Address - Fax:253-302-4223
Practice Address - Street 1:4606 108TH ST SW
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:WA
Practice Address - Zip Code:98499-4146
Practice Address - Country:US
Practice Address - Phone:253-693-2626
Practice Address - Fax:253-302-4223
Is Sole Proprietor?:No
Enumeration Date:2022-06-17
Last Update Date:2023-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106S00000X
WA1-23-64344103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician