Individual
MS. CRYSTAL L BURKERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
125 COLTS NECK RD, FARMINGDALE, NJ 07727
(856) 469-1374
Mailing address
125 COLTS NECK RD, FARMINGDALE, NJ 07727-3638
(856) 469-1374
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-18-33072
NJ
103K00000X
Behavior Analyst
11833702
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1-18-33072
BEHAVIOR ANALYST CERTIFICIATION BOARD
—
Enumeration date
04/10/2019
Last updated
04/10/2019
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