Basic Information
| Provider Information | |||||||||
| NPI: | 1932869955 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | KRONER | ||||||||
| FirstName: | JESSICA | ||||||||
| MiddleName: | |||||||||
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| Credential: | BCBA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6071 TOWN COLONY DR APT 9212 | ||||||||
| Address2: | |||||||||
| City: | BOCA RATON | ||||||||
| State: | FL | ||||||||
| PostalCode: | 334331909 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9548959862 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1239 E NEWPORT CENTER DR STE 101 | ||||||||
| Address2: | |||||||||
| City: | DEERFIELD BEACH | ||||||||
| State: | FL | ||||||||
| PostalCode: | 334427711 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7544443707 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/20/2021 | ||||||||
| LastUpdateDate: | 04/13/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 04/13/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 106E00000X | 0-21-13157 | FL | N | 103K00000X | 1-22-58706 | FL | Y | Behavioral Health & Social Service Providers | Behavioral Analyst |
No ID Information.