| NPI | 1083725519 |
|---|---|
| Former Name | CRYSTAL LEWIS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: AR P0512071) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: AR P0512071) |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2020-09-27 |