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General NPI Number Information
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NPI Number | 1891424396
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Entity Type | Individual
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Provider Name | KIMBERLY A CROSLAND BCBA-D
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Gender | Female
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Dates
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Enumeration Date | 06/09/2022
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Last Update Date | 06/24/2022
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Provider Practice Location Address
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Address Line | 113 SLOAN DR
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City | BROOKLAND
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State | AR
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Zip | 72417-9064
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Country | US
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Telephone | 813-967-5704
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Fax |
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Provider Business Mailing Address
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Address Line | 5828 TERNCREST DR
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City | LITHIA
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State | FL
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Zip | 33547-5876
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Country | US
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Telephone | 813-967-5704
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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 | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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