| NPI | 1578943197 |
|---|---|
| Former Name | CRYSTAL RUCKER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: NC A11521) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: NC A11521) |
| 101YM0800X Counselor, Mental Health (Licence: NC A11521) | |
| Enumeration Date | 2015-06-09 |
| Last Update Date | 2015-06-09 |