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Individual

CRYSTAL MONTE STEPHENS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
607 RUSSELL PKWY, WARNER ROBINS, GA 31088-7640
(478) 225-9860
Mailing address
406 COVINGTON CV, BYRON, GA 31008-9523
(478) 832-8735

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
MAT
MAT
GA
Enumeration date
11/02/2019
Last updated
11/02/2019
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