Blake Crusaw

Behavior Technician · Wellborn, FL

Individual Active NPI

NPI number 1639097801

Practice location

2725 188TH St
Wellborn, FL 32094-3344
Phone
(386) 205-5773

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NPI record

NPI
1639097801
Entity type
Individual (Type 1)
Enumeration date
July 7, 2026
Last updated
July 7, 2026
Certified
July 7, 2026
Sole proprietor
Yes

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Behavior Technician Primary 106S00000X — —

About Blake Crusaw

Blake Crusaw is a healthcare provider registered in the NPI registry with the primary taxonomy Behavior Technician (code 106S00000X). The practice location is 2725 188TH St, Wellborn, FL 32094-3344. The NPI number 1639097801 was assigned on July 7, 2026 and the record was last updated on July 7, 2026.

Frequently asked questions

What is the NPI number of Blake Crusaw?

The NPI number is 1639097801.

What is the phone number of Blake Crusaw?

The phone number listed for the practice location is (386) 205-5773.

Where is Blake Crusaw located?

2725 188TH St, Wellborn, FL 32094-3344.

What is the taxonomy code for Blake Crusaw?

The primary taxonomy code is 106S00000X – Behavior Technician.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.