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Individual

CRYSTAL JOY DAVIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
4840 GRASSELLI ST, EAST CHICAGO, IN 46312-3503
(219) 315-3956
Mailing address
1519 170TH ST APT 325, HAMMOND, IN 46324-2178

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary

Other

Enumeration date
07/16/2024
Last updated
03/13/2025
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