Individual
ANDREW CROSSMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BCBA
Contact information
Practice address
1560 MIDWAY DR, AMMON, ID 83406-6912
(208) 522-1217
Mailing address
1570 MIDWAY DR, AMMON, ID 83406-6912
(208) 709-0537
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-18-32244
ID
Other
Enumeration date
12/16/2018
Last updated
12/16/2018
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