| NPI | 1578815288 |
|---|---|
| Former Name | KRYSTLE GALLEGOS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MN 2405) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MN 303273) |
| Enumeration Date | 2012-10-04 |
| Last Update Date | 2021-05-26 |