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NPI Code Detail

MEDICARE: KRYSTAL MARIE TREADWELL

MEDICARE: KRYSTAL MARIE TREADWELL
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 : 1245195643
Entity Type Code : Individual
Provider Name (Legal Business Name) : KRYSTAL MARIE TREADWELL
Provider Business Mailing Address
First Line : 103B W CHERRY CREEK RD
Second Line :
City : MIO
State : MI
Zip : 48647-9378
Country : US
Telephone Number : 989-390-6297
Fax Number :
Provider Business Practice Location Address
First Line : PO BOX 392
Second Line :
City : TRAVERSE CITY
State : MI
Zip : 49685-0392
Country : US
Telephone Number : 231-268-0007
Fax Number : 231-525-3170
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/17/2025
Last Update Date : 12/17/2025

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Directions to “ KRYSTAL MARIE TREADWELL ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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