Provider Demographics
NPI:1609619550
Name:CLAYTON, KRISTY (RBT)
Entity type:Individual
Prefix:MRS
First Name:KRISTY
Middle Name:
Last Name:CLAYTON
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 ALANA LN
Mailing Address - Street 2:
Mailing Address - City:LEWISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17837-9319
Mailing Address - Country:US
Mailing Address - Phone:910-638-4978
Mailing Address - Fax:
Practice Address - Street 1:1722 W MARKET ST STE 4
Practice Address - Street 2:
Practice Address - City:LEWISBURG
Practice Address - State:PA
Practice Address - Zip Code:17837-1285
Practice Address - Country:US
Practice Address - Phone:570-435-8180
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-18
Last Update Date:2024-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician