| NPI | 1972938041 |
|---|---|
| Former Name | CRYSTAL SHIELDS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: VA 0701012867) |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YP2500X Counselor, Professional (Licence: HI MHC-745) | |
| Enumeration Date | 2013-09-09 |
| Last Update Date | 2025-05-14 |