Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106S00000X | Behavior Technician |
NPI | 1003407669 |
---|---|
Provider Name | Krystle Nicole Currington |
First Address | Crestview, FL 32536-2639 |
Second Address | Crestview, FL 32536-2639 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/01/2021 |
Last Update Date | 27/01/2021 |