| NPI | 1255079091 |
|---|---|
| Former Name | CRYSTAL BURRISS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: KY 251049) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: KY 278265) |
| Enumeration Date | 2022-05-23 |
| Last Update Date | 2025-07-08 |