Provider Demographics
NPI:1265934863
Name:OPASINA, CRYSTAL DELENOUS
Entity type:Individual
Prefix:
First Name:CRYSTAL
Middle Name:DELENOUS
Last Name:OPASINA
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 1:3817 MEMORY LN APT A
Mailing Address - Street 2:
Mailing Address - City:ABINGDON
Mailing Address - State:MD
Mailing Address - Zip Code:21009-2071
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:10451 MILL RUN CIR STE 400
Practice Address - Street 2:
Practice Address - City:OWINGS MILLS
Practice Address - State:MD
Practice Address - Zip Code:21117-5594
Practice Address - Country:US
Practice Address - Phone:443-695-2838
Practice Address - Fax:312-929-0324
Is Sole Proprietor?:No
Enumeration Date:2018-02-28
Last Update Date:2024-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician