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NPI Code Detail

MEDICARE: MANDY ISAAC CROOM RBT

MEDICARE: MANDY ISAAC CROOM RBT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1083570998
Entity Type Code : Individual
Provider Name (Legal Business Name) : MANDY ISAAC CROOM RBT
Provider Business Mailing Address
First Line : 44 SHUCKIN ST
Second Line :
City : HAMPSTEAD
State : NC
Zip : 28443-8729
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 44 SHUCKIN ST
Second Line :
City : HAMPSTEAD
State : NC
Zip : 28443-8729
Country : US
Telephone Number : 910-599-0033
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/05/2026
Last Update Date : 01/05/2026

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Directions to “ MANDY ISAAC CROOM RBT” Practice Location

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