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Individual
CRYSTAL STAR LYGHT
Active
Individual
CRYSTAL STAR LYGHT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ACLC
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
BBH-ACLC-LIC-78912
MT
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
BBH-LAC-LIC-88473
MT
Other
Enumeration date
06/09/2025
Last updated
06/07/2026
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