Individual
CRYSTAL MARIE CAMPUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1836 N CRYSTAL LAKE DR APT 72, LAKELAND, FL 33801-6587
(708) 205-8186
Mailing address
1836 N CRYSTAL LAKE DR APT 72, LAKELAND, FL 33801-6587
(708) 205-8186
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
FL
Other
Enumeration date
03/14/2024
Last updated
04/12/2024
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