| NPI | 1720616717 |
|---|---|
| Former Name | CRYSTAL SHEPPARD |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA 110171) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: TX 118478) |
| 1041C0700X Social Worker, Clinical (Licence: ME LC24019) | |
| Enumeration Date | 2020-03-27 |
| Last Update Date | 2026-09-11 |