| NPI | 1508575184 |
|---|---|
| Former Name | KRYSTAL LYNN MOORE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: ID 2061075) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA 146126) |
| Enumeration Date | 2022-11-22 |
| Last Update Date | 2025-05-08 |