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General NPI Number Information
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NPI Number | 1306352653
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Entity Type | Individual
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Provider Name | KRYSTOFER APPLETON
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Gender | Male
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Dates
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Enumeration Date | 12/22/2017
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Last Update Date | 12/22/2017
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Provider Practice Location Address
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Address Line | 908 HIGHLAND DR
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City | HINESVILLE
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State | GA
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Zip | 31313-6450
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Country | US
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Telephone | 678-964-9915
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Fax |
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Provider Business Mailing Address
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Address Line | 2200 E VICTORY DR APT 73
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City | SAVANNAH
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State | GA
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Zip | 31404-3965
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Country | US
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Telephone | 678-964-9915
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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 |
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License Number State | GA
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