Crystal Butterworth
Individual provider Active NPI Behavior Technician · Gulfport, MS
NPI 1700614567 · NPPES record last updated Jul 23, 2024
Key facts
- NPI
- 1700614567
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Behavior Technician 106S00000X
- Practice address
- 9480 Three Rivers Rd
Gulfport, MS 39503-4248 - Phone
- (251) 648-4346
- NPI assigned
- Jul 23, 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
9480 Three Rivers Rd
Gulfport, MS 39503-4248
Mailing address
9480 Three Rivers Rd
Gulfport, MS 39503-4248
Phone (251) 648-4346
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- Kathryn J. Bush
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- Danielle Marie Caillavet
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All providers in Gulfport, MS · Behavior Technician in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 23, 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.