| NPI | 1265740054 | 
|---|---|
| Former Name | CRYSTAL RUSK-TREMBLAY | 
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: KY 174800)  | 
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: OH E.1000088)  | 
| Enumeration Date | 2010-09-15 | 
| Last Update Date | 2019-12-09 |