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General NPI Number Information
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NPI Number | 1952219065
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Entity Type | Individual
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Provider Name | CRYSTAL JENIOUSE STANLEY
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Gender | Female
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Dates
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Enumeration Date | 08/31/2026
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Last Update Date | 08/31/2026
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Provider Practice Location Address
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Address Line | 207 SIMMONS ST
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City | MT PLEASANT
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State | SC
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Zip | 29464-4347
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Country | US
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Telephone | 843-367-5452
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Fax |
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Provider Business Mailing Address
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Address Line | 500 SUNNYSIDE WAY
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City | SUMMERVILLE
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State | SC
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Zip | 29485-4123
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Country | US
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Telephone | 843-628-8189
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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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