| NPI | 1568053098 |
|---|---|
| Former Name | CRYSTAL COREN LEE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: NE 113455) |
| Enumeration Date | 2021-01-28 |
| Last Update Date | 2024-09-13 |