Provider Demographics
NPI:1699296152
Name:ALDERMAN, CRYSTAL (BCBA)
Entity type:Individual
Prefix:MS
First Name:CRYSTAL
Middle Name:
Last Name:ALDERMAN
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3132
Mailing Address - Street 2:
Mailing Address - City:PLANT CITY
Mailing Address - State:FL
Mailing Address - Zip Code:33563-0003
Mailing Address - Country:US
Mailing Address - Phone:813-449-0222
Mailing Address - Fax:
Practice Address - Street 1:1463 OAKFIELD DR STE 102A
Practice Address - Street 2:
Practice Address - City:BRANDON
Practice Address - State:FL
Practice Address - Zip Code:33511-3893
Practice Address - Country:US
Practice Address - Phone:813-438-8902
Practice Address - Fax:813-438-8903
Is Sole Proprietor?:No
Enumeration Date:2017-07-05
Last Update Date:2019-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst