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Individual

KRYSTAL SAMUEL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
BCBA

Contact information

Practice address
350 PINECREST ST, ALPENA, MI 49707-1328
(989) 278-8878
Mailing address
PO BOX 663, LAKELAND, MI 48143-0663
(810) 599-2129

Taxonomy

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

Other

Enumeration date
09/15/2022
Last updated
03/03/2025
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