Provider Demographics
NPI:1932858834
Name:HIX, KRISTYNA (BCBA)
Entity Type:Individual
Prefix:
First Name:KRISTYNA
Middle Name:
Last Name:HIX
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4273 W 222ND ST APT 3
Mailing Address - Street 2:
Mailing Address - City:FAIRVIEW PARK
Mailing Address - State:OH
Mailing Address - Zip Code:44126-1858
Mailing Address - Country:US
Mailing Address - Phone:440-321-0999
Mailing Address - Fax:
Practice Address - Street 1:6537 BRECKSVILLE RD
Practice Address - Street 2:
Practice Address - City:INDEPENDENCE
Practice Address - State:OH
Practice Address - Zip Code:44131-4855
Practice Address - Country:US
Practice Address - Phone:216-503-1234
Practice Address - Fax:216-503-1233
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-20
Last Update Date:2022-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1-22-58181103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst