Individual
EGYPT CRIDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
634 N 12TH ST, MURRAY, KY 42071-1651
(270) 767-6404
Mailing address
181 W PROFESSIONAL PARK CT STE 1, BOWLING GREEN, KY 42104-3250
(270) 777-9283
(270) 777-9283
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
17-40358
IL
Other
Enumeration date
05/15/2018
Last updated
05/15/2018
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