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Individual
MRS. KRYSANDRA LYNN PHELAN
Active
Individual
MRS. KRYSANDRA LYNN PHELAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
6801089204
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1093983173
—
MI
Enumeration date
02/12/2008
Last updated
08/06/2012
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