MEDICARE: KRISTI TOWARD

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
1	103K00000X	Behavior Analyst	1-14-17604	NC

General Provider Information

NPI Number	:	1447648316
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KRISTI TOWARD

Provider Business Mailing Address
First Line	:	406 29TH AVE N
Second Line	:
City	:	MYRTLE BEACH
State	:	SC
Zip	:	29577-3006
Country	:	US
Telephone Number	:	724-986-3961
Fax Number	:

Provider Business Practice Location Address
First Line	:	406 PROVINCIAL ST
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27603-2382
Country	:	US
Telephone Number	:	724-986-3961
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/30/2014
Last Update Date	:	01/25/2021

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Directions to “ KRISTI TOWARD ” Practice Location

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