Provider Demographics
NPI:1205292224
Name:COX, KRISTEN MICHELLE (MAP, BCBA, LBA)
Entity type:Individual
Prefix:MRS
First Name:KRISTEN
Middle Name:MICHELLE
Last Name:COX
Suffix:
Gender:F
Credentials:MAP, BCBA, LBA
Other - Prefix:
Other - First Name:KRISTEN
Other - Middle Name:MICHELLE
Other - Last Name:AZOTEA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MAP, BCBA, LBA
Mailing Address - Street 1:10176 CORPORATE SQUARE DR
Mailing Address - Street 2:SUITE 150
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63132-2924
Mailing Address - Country:US
Mailing Address - Phone:314-432-6200
Mailing Address - Fax:
Practice Address - Street 1:10176 CORPORATE SQUARE DR
Practice Address - Street 2:SUITE 150
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63132-2924
Practice Address - Country:US
Practice Address - Phone:314-432-6200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-01-06
Last Update Date:2016-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2015043648103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst