| NPI | 1740372440 |
|---|---|
| Former Name | CHRYSTAL D EDGE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC1900X Psychologist, Counseling (Licence: KY 1459) |
| Additional Taxonomies | 103TC1900X Psychologist, Counseling (Licence: KY 2005-80) |
| Enumeration Date | 2006-09-29 |
| Last Update Date | 2015-09-17 |