Doctor Name: | MRS. KRYSTAL NICOLE MACHADO |
NPI Number: | 1093140303 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MA, CAGS |
License Number: | 455491 |
Business Practice Address: | 1 Washington Street Taunton, MA - 02780 |
Business Phone Number: | 5088235400 |
Business Fax Number: | |
Mailing Address: | 1 Washington Street, TAUNTON |
State: | MA |
Postal Code: | 02780 |
Phone Number: | 5088235400 |
Fax Number: | |
NPI Enumeration Date: | 09/05/2013 |
NPI Last Update Date: | 09/25/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TS0200X |
License Number: | 455491 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | School |
Taxonomy Definition: |