MEDICARE: AMBERLEE KRON M.A., B.C.B.A.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103K00000X	Behavior Analyst	L-145	LA

General Provider Information

NPI Number	:	1093179384
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMBERLEE KRON M.A., B.C.B.A.

Provider Business Mailing Address
First Line	:	4205 RYAN ST BOX 91895
Second Line	:
City	:	LAKE CHARLES
State	:	LA
Zip	:	70609-1895
Country	:	US
Telephone Number	:	337-562-4246
Fax Number	:	337-562-4221

Provider Business Practice Location Address
First Line	:	4205 RYAN ST BOX 91895
Second Line	:
City	:	LAKE CHARLES
State	:	LA
Zip	:	70609-1895
Country	:	US
Telephone Number	:	337-562-4246
Fax Number	:	337-562-4221

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/12/2016
Last Update Date	:	04/12/2016

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