Healthcare Provider Details

I. General information

NPI: 1326951344
Provider Name (Legal Business Name): CRYSTAL GAFFNEY
Entity Type: Individual
Gender:
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/23/2026
Last Update Date: 09/23/2026
Certification Date: 09/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

119 SHADY HILL DR
UNION SC
29379-9419
US

IV. Provider business mailing address

119 SHADY HILL DR
UNION SC
29379-9419
US

V. Phone/Fax

Practice location:
  • Phone: 864-762-0681
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: