| NPI | 1659968683 |
|---|---|
| Former Name | CRYSTAL MICHELLE WILLIS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 104100000X Social Worker (Licence: TN 10879) |
| Additional Taxonomies | 1041C0700X Social Worker Clinical (Licence: TN 9140) |
| Enumeration Date | 2020-12-23 |
| Last Update Date | 2024-11-22 |