1982264651 NPI number — MS. CHRYSTAL LYNNE ATKINSON BCBA

Table of content: MS. CHRYSTAL LYNNE ATKINSON BCBA (NPI 1982264651)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1982264651 NPI number — MS. CHRYSTAL LYNNE ATKINSON BCBA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ATKINSON
Provider First Name:
CHRYSTAL
Provider Middle Name:
LYNNE
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
BCBA
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
REED
Provider Other First Name:
CHRYSTAL
Provider Other Middle Name:
LYNNE
Provider Other Name Prefix Text:
MRS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1982264651
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/15/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
920 TWIN BRIDGES RD APT 117
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ALEXANDRIA
Provider Business Mailing Address State Name:
LA
Provider Business Mailing Address Postal Code:
71303-2074
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
318-491-0305
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5731 JACKSON ST STE B&C
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ALEXANDRIA
Provider Business Practice Location Address State Name:
LA
Provider Business Practice Location Address Postal Code:
71303-7022
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
318-704-6470
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/15/2019

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 103K00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)