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Individual

AMBER NICOLE CRUDUP

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MA, BCBA, LBA

Contact information

Practice address
614 N 6TH ST STE B, SPRINGFIELD, IL 62702-5314
(217) 295-2491
Mailing address
614 N 6TH ST STE B, SPRINGFIELD, IL 62702-5314
(217) 295-2491

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
106S00000X
Behavior Technician

Other

Enumeration date
12/18/2017
Last updated
06/10/2025
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