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1447380712
CRYSTAL LOUISE KAVANAUGH
LITTLE ROCK, AR
NPI
1447380712
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YM0800X Counselor, Mental Health
(Licence: AR Provisional)
Enumeration Date
2007-03-06
Last Update Date
2007-07-08
Business Address
Mr. CRYSTAL LOUISE KAVANAUGH LPE (provisional)
5905 FOREST PL
LITTLE ROCK, AR 72207-5244
Phone number: 501-666-4949
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Mailing Address
Mr. CRYSTAL LOUISE KAVANAUGH LPE (provisional)
PO BOX 251970
LITTLE ROCK, AR 72225-1970
Phone number: 501-666-8686
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