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General NPI Number Information
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NPI Number | 1184399230
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Entity Type | Individual
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Provider Name | CRYSTAL L NIEVES RBT
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Gender | Female
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Dates
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Enumeration Date | 08/11/2021
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Last Update Date | 08/11/2021
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Provider Practice Location Address
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Address Line | 3700 CURRY FORD RD APT Z18
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City | ORLANDO
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State | FL
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Zip | 32806-2673
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Country | US
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Telephone | 610-570-2279
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Fax |
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Provider Business Mailing Address
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Address Line | 3700 CURRY FORD RD APT Z18
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City | ORLANDO
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State | FL
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Zip | 32806-2673
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Country | US
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Telephone | 610-570-2279
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number | RBT-21-179568
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License Number State | FL
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