| NPI | 1902493109 |
|---|---|
| Former Name | KRYSTLE MANLEY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106S00000X Behavior Technician |
| Additional Taxonomies | 222Q00000X Developmental Therapist |
| Enumeration Date | 2020-12-22 |
| Last Update Date | 2025-02-25 |