Individual
CRYSTAL S MACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RBT
Contact information
Practice address
632 EASTERN BLVD, CLARKSVILLE, IN 47129-2454
(812) 725-9025
(317) 663-1175
Mailing address
12650 HAMILTON CROSSING BLVD, CARMEL, IN 46032-5400
(317) 249-2242
(317) 663-1175
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
07/06/2018
Last updated
07/06/2018
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