| NPI | 1497989172 |
|---|---|
| Former Name | CRYSTAL A COFFEY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1835P1300X Pharmacist, Psychiatric (Licence: TX 52625) |
| Additional Taxonomies | 1835P1300X Pharmacist, Psychiatric (Licence: WA PH60073856) |
| Enumeration Date | 2009-05-08 |
| Last Update Date | 2013-05-20 |