Provider Demographics
NPI:1639988686
Name:EMBRY, KRISTEN NICOLE (ABA)
Entity type:Individual
Prefix:MS
First Name:KRISTEN
Middle Name:NICOLE
Last Name:EMBRY
Suffix:
Gender:F
Credentials:ABA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1384 WESLEY CHAPEL RD
Mailing Address - Street 2:
Mailing Address - City:WACO
Mailing Address - State:TX
Mailing Address - Zip Code:76705-6023
Mailing Address - Country:US
Mailing Address - Phone:254-498-7777
Mailing Address - Fax:
Practice Address - Street 1:7215 BOSQUE BLVD
Practice Address - Street 2:
Practice Address - City:WACO
Practice Address - State:TX
Practice Address - Zip Code:76710-4020
Practice Address - Country:US
Practice Address - Phone:855-832-6727
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-04
Last Update Date:2025-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst