Provider Demographics
NPI:1386266385
Name:CRAIN SZYMANSKI, TEENA MARIE
Entity type:Individual
Prefix:
First Name:TEENA
Middle Name:MARIE
Last Name:CRAIN SZYMANSKI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:91-1037 WAIKAPOO ST
Mailing Address - Street 2:
Mailing Address - City:EWA BEACH
Mailing Address - State:HI
Mailing Address - Zip Code:96706-6464
Mailing Address - Country:US
Mailing Address - Phone:808-557-7892
Mailing Address - Fax:
Practice Address - Street 1:91-1037 WAIKAPOO ST
Practice Address - Street 2:
Practice Address - City:EWA BEACH
Practice Address - State:HI
Practice Address - Zip Code:96706-6464
Practice Address - Country:US
Practice Address - Phone:808-557-7892
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-12
Last Update Date:2020-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician