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 |