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NPI Code Detail

MEDICARE: CRYSTAL MARSH RBT

MEDICARE: CRYSTAL MARSH 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 TechnicianRBT-22-218436TN

General Provider Information

NPI Number : 1831814052
Entity Type Code : Individual
Provider Name (Legal Business Name) : CRYSTAL MARSH RBT
Provider Business Mailing Address
First Line : 9038 CROSS PARK DR STE 105
Second Line :
City : KNOXVILLE
State : TN
Zip : 37923-4729
Country : US
Telephone Number : 865-394-6612
Fax Number : 865-315-7014
Provider Business Practice Location Address
First Line : 9038 CROSS PARK DR STE 105
Second Line :
City : KNOXVILLE
State : TN
Zip : 37923-4729
Country : US
Telephone Number : 865-394-6612
Fax Number : 865-315-7014
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/10/2022
Last Update Date : 03/09/2026

Similar Medicare Providers

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Practice Location Address:
9038 CROSS PARK DR STE 105
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1902797319 — HEATHER SHOFFNER
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1063367217 — SAMANTHA A KOLYER
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37923-4729
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1639488059 — NICOLE CARTER B.A.
Practice Location Address:
9038 CROSS PARK DR STE 105
KNOXVILLE, TN
37923-4729
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Practice Fax: 865-315-7014
1255712931 — MRS. TAYLOR UHER
Practice Location Address:
9038 CROSS PARK DR STE 105
KNOXVILLE, TN
37923-4729
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1942793872 — THERON KEITH UNDERWOOD BCBA
Practice Location Address:
9038 CROSS PARK DR STE 105
KNOXVILLE, TN
37923-4729
Practice Phone: 865-394-6612
Practice Fax: 865-315-7014

Directions to “ CRYSTAL MARSH RBT” Practice Location

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