Individual
CRYSTAL DIANE COLUMBIA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1171 BRIDGETON RD, FAWN GROVE, PA 17321-9320
(443) 417-4800
Mailing address
1171 BRIDGETON RD, FAWN GROVE, PA 17321-9320
(443) 417-4800
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
—
—
106S00000X
Behavior Technician
Primary
—
—
174H00000X
Health Educator
—
—
Other
Enumeration date
07/17/2023
Last updated
07/17/2023
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