Provider Demographics
NPI:1043548829
Name:TINDELL, KRISTIN LEIGH (BCBA)
Entity type:Individual
Prefix:
First Name:KRISTIN
Middle Name:LEIGH
Last Name:TINDELL
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1020 TRIMMIER RD
Mailing Address - Street 2:
Mailing Address - City:KILLEEN
Mailing Address - State:TX
Mailing Address - Zip Code:76541-8029
Mailing Address - Country:US
Mailing Address - Phone:254-760-0494
Mailing Address - Fax:
Practice Address - Street 1:1020 TRIMMIER RD
Practice Address - Street 2:
Practice Address - City:KILLEEN
Practice Address - State:TX
Practice Address - Zip Code:76541-8029
Practice Address - Country:US
Practice Address - Phone:254-760-0494
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-06
Last Update Date:2025-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX64928101YP2500X
0-02-0525103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional