Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst | ||
N | 103K00000X | Behavior Analyst | TX |
NPI | 1003206533 |
---|---|
Provider Name | Ms. Crysta Suzette Perkins |
First Address | Denton, TX 76205-7768 |
Second Address | Denton, TX 76205 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/02/2015 |
Last Update Date | 15/08/2018 |