Individual
KRISTA JADE LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
300 N 10TH ST, GAS CITY, IN 46933-1605
(888) 877-7222
Mailing address
935 LEXINGTON AVE, FORT WAYNE, IN 46807-2126
(773) 759-3964
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-20-45125
—
103K00000X
Behavior Analyst
—
—
106E00000X
Assistant Behavior Analyst
0-19-9898
IN
Other
Enumeration date
06/27/2019
Last updated
05/23/2024
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