Individual
CRYSTAL EDWARDS HINES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
8596 W MARLBORO RD, FARMVILLE, FARMVILLE, NC 27828-8509
(252) 229-7148
Mailing address
8596 W MARLBORO RD, FARMVILLE, FARMVILLE, NC 27828-8509
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
222Q00000X
Developmental Therapist
—
—
Other
Enumeration date
03/11/2016
Last updated
01/31/2018
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