Individual
MISS CRYSTAL MARIE LE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
5203 52ND AVE W, BRADENTON, FL 34210-4709
(619) 339-3644
Mailing address
5203 52ND AVE W, BRADENTON, FL 34210-4709
(619) 339-3644
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
127410
MA
1041C0700X
Clinical Social Worker
Primary
21755
FL
1041C0700X
Clinical Social Worker
60521
CA
Other
Enumeration date
06/01/2010
Last updated
06/19/2024
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