MEDICARE: MS. KRISTIN ALYSE ROWLAND MS, BCBA

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number
1	106E00000X	Assistant Behavior Analyst
2	106S00000X	Behavior Technician	RBT-16-25664
3	103K00000X	Behavior Analyst	1-18-33147

General Provider Information

NPI Number	:	1609351352
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. KRISTIN ALYSE ROWLAND MS, BCBA

Provider Business Mailing Address
First Line	:	10419 CALUMET AVE STE B
Second Line	:
City	:	MUNSTER
State	:	IN
Zip	:	46321-4059
Country	:	US
Telephone Number	:	219-491-1759
Fax Number	:

Provider Business Practice Location Address
First Line	:	10419 CALUMET AVE STE B
Second Line	:
City	:	MUNSTER
State	:	IN
Zip	:	46321-4059
Country	:	US
Telephone Number	:	219-491-1759
Fax Number	:

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

Provider Enumeration Date	:	09/28/2018
Last Update Date	:	02/19/2024

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