| NPI | 1376215723 |
|---|---|
| Former Name | CRYSTAL C MILLESS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 175T00000X Peer Specialist (Licence: CA MPSS-LBFNXT) |
| Additional Taxonomies | 172V00000X Community Health Worker |
| Enumeration Date | 2021-10-04 |
| Last Update Date | 2024-11-13 |