CRYSTAL LOUISE KAVANAUGH

LITTLE ROCK, AR
NPI1447380712
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy101YM0800X Counselor, Mental Health
(Licence: AR  Provisional)
Enumeration Date2007-03-06
Last Update Date2007-07-08
Business Address
Mr. CRYSTAL LOUISE KAVANAUGH LPE (provisional)
5905 FOREST PL
LITTLE ROCK, AR 72207-5244
Phone number: 501-666-4949
Mailing Address
Mr. CRYSTAL LOUISE KAVANAUGH LPE (provisional)
PO BOX 251970
LITTLE ROCK, AR 72225-1970
Phone number: 501-666-8686