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1063088706
CRYSTAL THERESA SMALL
UPPER MARLBORO, MD
NPI
1063088706
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
101YM0800X Counselor, Mental Health
(Licence: MD LGP8829)
Enumeration Date
2021-06-02
Last Update Date
2021-06-02
Business Address
CRYSTAL THERESA SMALL
9500 MEDICAL CENTER DR
UPPER MARLBORO, MD 20774-3701
Phone number: 202-831-2865
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Mailing Address
CRYSTAL THERESA SMALL
9200 EDWARDS WAY APT 317
HYATTSVILLE, MD 20783-3456
Phone number: 301-830-0887
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