NPI | 1528309929 |
---|---|
Former Name | CRYSTAL COLUSSI |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CO CSW.09923914) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CO ACD.0000500) |
Enumeration Date | 2013-03-09 |
Last Update Date | 2020-11-06 |