Provider Demographics
NPI:1780293761
Name:WARD, KRISTA L (RBT)
Entity type:Individual
Prefix:MISS
First Name:KRISTA
Middle Name:L
Last Name:WARD
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:MISS
Other - First Name:KRISTA
Other - Middle Name:L
Other - Last Name:WARD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RBT
Mailing Address - Street 1:12760 W 87TH STREET PKWY
Mailing Address - Street 2:
Mailing Address - City:LENEXA
Mailing Address - State:KS
Mailing Address - Zip Code:66215-4635
Mailing Address - Country:US
Mailing Address - Phone:913-203-8398
Mailing Address - Fax:
Practice Address - Street 1:12760 W 87TH STREET PKWY
Practice Address - Street 2:
Practice Address - City:LENEXA
Practice Address - State:KS
Practice Address - Zip Code:66215-4635
Practice Address - Country:US
Practice Address - Phone:913-203-8398
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-27
Last Update Date:2020-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician