Provider Demographics
NPI:1356703151
Name:TEJEDA, KRISTINA NOEL (MS, BCBA)
Entity type:Individual
Prefix:
First Name:KRISTINA
Middle Name:NOEL
Last Name:TEJEDA
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 1:216 GAYLE AVE
Mailing Address - Street 2:
Mailing Address - City:DEKALB
Mailing Address - State:IL
Mailing Address - Zip Code:60115-4318
Mailing Address - Country:US
Mailing Address - Phone:815-919-4814
Mailing Address - Fax:
Practice Address - Street 1:1920 THOREAU DR N
Practice Address - Street 2:#180
Practice Address - City:SCHAUMBURG
Practice Address - State:IL
Practice Address - Zip Code:60173-4176
Practice Address - Country:US
Practice Address - Phone:847-496-5513
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-03-22
Last Update Date:2016-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst