| NPI | 1811249048 |
|---|---|
| Former Name | CRYSTAL DAWN WITTY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: KS 4761) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: OK 21113) |
| 1041C0700X Social Worker, Clinical (Licence: MO 2022021360) | |
| Enumeration Date | 2012-10-11 |
| Last Update Date | 2024-08-27 |