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NPI Code Detail

MEDICARE: MRS. CRYSTAL S. BEISWENGER

MEDICARE:  MRS. CRYSTAL S. BEISWENGER
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
1103K00000XBehavior Analyst1-09-5067IN

General Provider Information

NPI Number : 1851542476
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. CRYSTAL S. BEISWENGER
Provider Business Mailing Address
First Line : 2630 S ARLINGTON AVE
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46203-5701
Country : US
Telephone Number : 317-966-0200
Fax Number : 317-522-1944
Provider Business Practice Location Address
First Line : 2630 S ARLINGTON AVE
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46203-5701
Country : US
Telephone Number : 317-966-0200
Fax Number : 317-522-1944
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/01/2008
Last Update Date : 02/05/2020

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Directions to “ MRS. CRYSTAL S. BEISWENGER ” Practice Location

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