| NPI | 1083156582 |
|---|---|
| Former Name | CRYSTAL NIKIA GRAY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NC A10494) |
| Additional Taxonomies | 101YS0200X Counselor, School (Licence: NC 1167989) |
| Enumeration Date | 2016-11-15 |
| Last Update Date | 2022-07-19 |