Most Relevant Information
Provider Data
| NPI Number: | 1003274481 |
| Provider Name: | KRYSTINA MANTZOURANIS |
| Entity Type: | Individual |
| Taxonomy Code: | 103K00000X |
| Specialty: | Behavior Analyst |
| License Number: |
Most Important Dates
| Enumeration Date: | 02/01/2016 |
| Last Updated: | 08/11/2019 |
Provider Practice Location
2685 LEEDS AVE
NORTH CHARLESTON
SC
294056861
Practice Location Phone/Fax
| Phone: | 8435293130 |
| Fax: |
Provider Mailing Location
1575 NANTAHALA BLVD
MOUNT PLEASANT
SC
294649753
Provider Mailing Phone/Fax
| Phone: | 7576421452 |
| Fax: |