| |
108 Liberty Sq Hurricane WV 25526-8809 | |
(304) 840-1585 | |
Not Available |
Full Name | |
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Speciality | Behavior Analyst |
Location | 108 Liberty Sq, Hurricane, West Virginia |
Authorized Official Name and Position | Christopher Michael Crytzer (OWNER) |
Authorized Official Contact | 3048401585 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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108 Liberty Sq Hurricane WV 25526-8809 Ph: (304) 840-1585 | 108 Liberty Sq Hurricane WV 25526-8809 Ph: (304) 840-1585 |
NPI Number | 1033816129 |
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Provider Enumeration Date | 02/09/2023 |
Last Update Date | 05/08/2023 |
Certification Date | 05/08/2023 |
Identifier | Type | State | Issuer |
---|---|---|---|
1033816129 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
261QD1600X | Clinic/center - Developmental Disabilities | (* (Not Available)) | Secondary |
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