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General NPI Number Information
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NPI Number | 1336519164
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Entity Type | Individual
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Provider Name | KRISTEN STINE M.ED, BCBA
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Gender | Female
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Dates
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Enumeration Date | 10/06/2015
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Last Update Date | 12/04/2025
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Provider Practice Location Address
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Address Line | 2546 E 2ND ST
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City | CASPER
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State | WY
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Zip | 82609-2062
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Country | US
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Telephone | 484-643-8954
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Fax |
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Provider Business Mailing Address
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Address Line | 14202 W EVANS CIR
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City | LAKEWOOD
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State | CO
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Zip | 80228-5991
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Country | US
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Telephone | 484-643-8954
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 11519166
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License Number State | CO
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