Provider Demographics
NPI:1649544206
Name:SCOTT HUWYLER, KRYSTIN (MSW, BCBA, LBA)
Entity type:Individual
Prefix:MS
First Name:KRYSTIN
Middle Name:
Last Name:SCOTT HUWYLER
Suffix:
Gender:F
Credentials:MSW, BCBA, LBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7311 SELMA DR
Mailing Address - Street 2:
Mailing Address - City:FENTON
Mailing Address - State:MI
Mailing Address - Zip Code:48430-9015
Mailing Address - Country:US
Mailing Address - Phone:210-262-1510
Mailing Address - Fax:
Practice Address - Street 1:1308 WAUKEGAN RD STE 103
Practice Address - Street 2:
Practice Address - City:GLENVIEW
Practice Address - State:IL
Practice Address - Zip Code:60025-3070
Practice Address - Country:US
Practice Address - Phone:877-486-4140
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-02-29
Last Update Date:2022-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1-12-10389103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst