| NPI | 1922541226 |
|---|---|
| Former Name | CRYSTAL LAUREN CHAVEZ |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NC P011086) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC 23373) |
| Enumeration Date | 2016-11-18 |
| Last Update Date | 2021-05-27 |