Krystal Zue Canales Crespo

Individual provider Active NPI Assistant Behavior Analyst · Fort Myers, FL

NPI 1922586718 · NPPES record last updated Aug 18, 2019

Key facts

NPI
1922586718
Entity type
Individual (NPI type 1)
Primary specialty
Assistant Behavior Analyst 106E00000X
Practice address
8359 Beacon Blvd Ste 416
Fort Myers, FL 33907-3065
Phone
(786) 972-4700
NPI assigned
Aug 2, 2018
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)CodeLicenseStatePrimary
Assistant Behavior Analyst 106E00000X FL Yes

Addresses

Primary practice location

8359 Beacon Blvd Ste 416
Fort Myers, FL 33907-3065

Mailing address

10030 Shephard St Apt 304
Estero, FL 33967-8404

Other practice location 1

10030 Shephard St Apt 304
Estero, FL 33967-8404
Phone (407) 932-8312

Other providers in Fort Myers, FL

All providers in Fort Myers, FL · Assistant Behavior Analyst in Florida

Sources for this page

Verify at the official NPI Registry.