MEDICARE: KRISTABEL ESPINAL

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	106S00000X	Behavior Technician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1639959869
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KRISTABEL ESPINAL

Provider Business Mailing Address
First Line	:	3407 HELENA SPRINGS LN APT A
Second Line	:
City	:	AUGUSTA
State	:	GA
Zip	:	30909-8030
Country	:	US
Telephone Number	:	407-350-7004
Fax Number	:

Provider Business Practice Location Address
First Line	:	1237 AUGUSTA WEST PKWY
Second Line	:
City	:	AUGUSTA
State	:	GA
Zip	:	30909-1807
Country	:	US
Telephone Number	:	762-685-4340
Fax Number	:

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

Provider Enumeration Date	:	10/04/2023
Last Update Date	:	02/05/2026

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Directions to “ KRISTABEL ESPINAL ” Practice Location

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