Provider Demographics
NPI:1376804401
Name:ROBERTS, KRISTEN (MS ED/TVI)
Entity type:Individual
Prefix:
First Name:KRISTEN
Middle Name:
Last Name:ROBERTS
Suffix:
Gender:F
Credentials:MS ED/TVI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:203 SARA CT
Mailing Address - Street 2:
Mailing Address - City:SCHENECTADY
Mailing Address - State:NY
Mailing Address - Zip Code:12308-1074
Mailing Address - Country:US
Mailing Address - Phone:518-421-2332
Mailing Address - Fax:
Practice Address - Street 1:203 SARA CT
Practice Address - Street 2:
Practice Address - City:SCHENECTADY
Practice Address - State:NY
Practice Address - Zip Code:12308-1074
Practice Address - Country:US
Practice Address - Phone:518-421-2332
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-05
Last Update Date:2024-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist