Koenig, Crystal Chadderton

Koenig, Crystal Chadderton is an individual health care provider with primary practice located at 910 N Jefferson St , Jacksonville FL 32209-6810. She recently has 2 registered licenses in different health care specialties including Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Developmental Therapist, Other Service Providers / Case Manager/Care Coordinator. Other Service Providers / Case Manager/Care Coordinator is her primary health care specialty. Koenig, Crystal Chadderton can be contacted via phone (904) 360-7022.

Contact Information

Primary practice address
910 N Jefferson St Jacksonville FL 32209-6810
Fax: (904) 798-4545
Website:

Profile Details

NPI number 1578781233
LBN Legal business name Koenig, Crystal Chadderton
Credentials Master of Education (MED)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 20th, 2007
Last updated Oct 28th, 2013 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1578781233 NPPES
Florida MEDICAID 811897300

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