Provider Demographics
NPI:1598260960
Name:CROSBIE, CARYN (RBT)
Entity Type:Individual
Prefix:
First Name:CARYN
Middle Name:
Last Name:CROSBIE
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 1:6260 139TH AVE NE APT 76
Mailing Address - Street 2:
Mailing Address - City:REDMOND
Mailing Address - State:WA
Mailing Address - Zip Code:98052-9702
Mailing Address - Country:US
Mailing Address - Phone:425-749-8496
Mailing Address - Fax:
Practice Address - Street 1:22526 SE 64TH PLACE
Practice Address - Street 2:BUILDING D SUITE 210
Practice Address - City:ISSAQUAH
Practice Address - State:WA
Practice Address - Zip Code:98029
Practice Address - Country:US
Practice Address - Phone:425-443-2940
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-28
Last Update Date:2018-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician