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1669339156 NPI number — ZACHARY K CRUTCHFIELD

NPI Number: 1669339156
Health Care Provider/Practitioner: ZACHARY K CRUTCHFIELD

Information about “1669339156” NPI (ZACHARY K CRUTCHFIELD) exists in 1669339156 in HTML format HTML  |  1669339156 in plain Text format TXT  |  1669339156 in PDF (Portable Document Format) PDF  |  1669339156 in an XML format XML  formats.

NPI Number : 1669339156 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1669339156",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "CRUTCHFIELD",
    "FirstName": "ZACHARY",
    "MiddleName": "K",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "9455 FORESTVIEW CIR",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "GRAND BLANC",
    "MailingAddressStateName": "MI",
    "MailingAddressPostalCode": "48439-8057",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "810-515-5979",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "12319 HIGHLAND RD STE 301",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "HARTLAND",
    "PracticeLocationAddressStateName": "MI",
    "PracticeLocationAddressPostalCode": "48353-2946",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "248-714-8445",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "01/06/2026",
    "LastUpdateDate": "01/06/2026",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "M",
    "Gender": "Male",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "106S00000X",
        "TaxonomyName": "Behavior Technician",
        "LicenseNumber": null,
        "LicenseNumberStateCode": "MI",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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