Provider Demographics
NPI:1841735586
Name:JANSSON, KRISTEN (MS, BCBA, LABA)
Entity Type:Individual
Prefix:
First Name:KRISTEN
Middle Name:
Last Name:JANSSON
Suffix:
Gender:F
Credentials:MS, BCBA, LABA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:260 WESTFIELD RD
Mailing Address - Street 2:
Mailing Address - City:HOLYOKE
Mailing Address - State:MA
Mailing Address - Zip Code:01040-1662
Mailing Address - Country:US
Mailing Address - Phone:413-534-3299
Mailing Address - Fax:413-534-6834
Practice Address - Street 1:260 WESTFIELD RD
Practice Address - Street 2:
Practice Address - City:HOLYOKE
Practice Address - State:MA
Practice Address - Zip Code:01040-1662
Practice Address - Country:US
Practice Address - Phone:413-534-3299
Practice Address - Fax:413-534-6834
Is Sole Proprietor?:No
Enumeration Date:2017-01-05
Last Update Date:2017-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA744103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst