Individual
CRYSTA NADIEN GOODMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RBT
Contact information
Practice address
5948 FISHER RD, FAYETTEVILLE, NC 28304-5640
(910) 401-2870
Mailing address
111 MACKENAN DR, CARY, NC 27511-7903
(919) 371-2848
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
NC
Other
Enumeration date
07/26/2017
Last updated
07/26/2017
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