Provider Demographics
NPI:1609351352
Name:ROWLAND, KRISTIN ALYSE (MS, BCBA)
Entity type:Individual
Prefix:MS
First Name:KRISTIN
Middle Name:ALYSE
Last Name:ROWLAND
Suffix:
Gender:F
Credentials:MS, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10419 CALUMET AVE STE B
Mailing Address - Street 2:
Mailing Address - City:MUNSTER
Mailing Address - State:IN
Mailing Address - Zip Code:46321-4059
Mailing Address - Country:US
Mailing Address - Phone:219-491-1759
Mailing Address - Fax:
Practice Address - Street 1:10419 CALUMET AVE STE B
Practice Address - Street 2:
Practice Address - City:MUNSTER
Practice Address - State:IN
Practice Address - Zip Code:46321-4059
Practice Address - Country:US
Practice Address - Phone:219-491-1759
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-28
Last Update Date:2024-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106E00000X
RBT-16-25664106S00000X
1-18-33147103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician