Crystal Howard Terry, RBT
Individual provider Active NPI Behavior Technician · Dallas, GA
NPI 1295572634 · NPPES record last updated Jul 12, 2024
Key facts
- NPI
- 1295572634
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Behavior Technician 106S00000X
- Practice address
- 168 N Johnston St
Dallas, GA 30132-4739 - Phone
- (678) 899-2608
- NPI assigned
- Jul 12, 2024
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | Yes |
Addresses
Primary practice location
168 N Johnston St
Dallas, GA 30132-4739
Mailing address
168 N Johnston St
Dallas, GA 30132-4739
Phone (678) 899-2608
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All providers in Dallas, GA · Behavior Technician in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 12, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.