Provider Demographics
NPI:1811307143
Name:CRONHEIM, KALEY
Entity type:Individual
Prefix:MS
First Name:KALEY
Middle Name:
Last Name:CRONHEIM
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:KALEY
Other - Middle Name:
Other - Last Name:KONIKOW
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:833 HURRICANE SHOALS RD NE
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30043-4821
Mailing Address - Country:US
Mailing Address - Phone:833-628-8476
Mailing Address - Fax:770-200-1563
Practice Address - Street 1:833 HURRICANE SHOALS RD NE
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30043-4821
Practice Address - Country:US
Practice Address - Phone:833-628-8476
Practice Address - Fax:770-200-1563
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-08
Last Update Date:2024-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106E00000X
GA1-21-53148103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst