Provider Demographics
NPI:1952781833
Name:KRONENFELD, STEFANIE (MS,BCBA)
Entity Type:Individual
Prefix:
First Name:STEFANIE
Middle Name:
Last Name:KRONENFELD
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 1:48 SPRING ST
Mailing Address - Street 2:APT 2
Mailing Address - City:WEST ROXBURY
Mailing Address - State:MA
Mailing Address - Zip Code:02132-3908
Mailing Address - Country:US
Mailing Address - Phone:908-770-7977
Mailing Address - Fax:
Practice Address - Street 1:48 SPRING ST
Practice Address - Street 2:APT 2
Practice Address - City:WEST ROXBURY
Practice Address - State:MA
Practice Address - Zip Code:02132-3908
Practice Address - Country:US
Practice Address - Phone:908-770-7977
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-04
Last Update Date:2017-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
1-14-9451OtherBEHAVIOR ANALYSIS CERTIFICATION BOARD