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1508049230
CRYSTAL LYNN BUSHONG
PRESCOTT, AZ
NPI
1508049230
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
320800000X Community Based Residential Treatment Facility, Mental Illness
Enumeration Date
2007-12-17
Last Update Date
2007-12-17
Business Address
Ms. CRYSTAL LYNN BUSHONG
2105 DEMERSE AVE
PRESCOTT, AZ 86301-1013
Phone number: 928-717-8834
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Mailing Address
Ms. CRYSTAL LYNN BUSHONG
2105 DEMERSE AVE
PRESCOTT, AZ 86301-1013
Phone number: 928-717-8834
Copy
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