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Individual

MRS. CRYSTAL ANN BOSTOW LIDDYCOAT

Active
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Individual

MRS. CRYSTAL ANN BOSTOW LIDDYCOAT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MA, LAC, LPC

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
1596
ND
101YM0800X
Mental Health Counselor
Primary
621-12-15-08
ND
101YM0800X
Mental Health Counselor
CP6207-R
NV

Other

Enumeration date
03/04/2009
Last updated
01/13/2026
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