Provider Demographics
NPI:1902232119
Name:OLBRYCH, KRISTEN (MS, BCBA)
Entity Type:Individual
Prefix:MISS
First Name:KRISTEN
Middle Name:
Last Name:OLBRYCH
Suffix:
Gender:F
Credentials:MS, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 BROOKSIDE RD
Mailing Address - Street 2:
Mailing Address - City:REDDING
Mailing Address - State:CT
Mailing Address - Zip Code:06896-3102
Mailing Address - Country:US
Mailing Address - Phone:203-770-2737
Mailing Address - Fax:
Practice Address - Street 1:25 BROOKSIDE RD
Practice Address - Street 2:
Practice Address - City:REDDING
Practice Address - State:CT
Practice Address - Zip Code:06896-3102
Practice Address - Country:US
Practice Address - Phone:203-770-2737
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-19
Last Update Date:2016-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT1-16-23483103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst