Individual
KRYSTAL CELESTE JAVIER SAMUEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA, LBA
Contact information
Practice address
739 THIMBLE SHOALS BLVD STE 302, NEWPORT NEWS, VA 23606-3562
(866) 565-7222
(877) 734-1914
Mailing address
2 VILLAGE SQ STE 210, BALTIMORE, MD 21210-1624
(609) 525-4271
(443) 743-3863
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-22-57726
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1194231639
—
VA
Enumeration date
12/20/2017
Last updated
09/21/2023
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