Individual
CRYSTAL OLIVIA MITCHELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2180 JOHNSON AVE, SAN LUIS OBISPO, CA 93401-4513
(805) 266-0790
Mailing address
2240 EMILY ST UNIT 201, SAN LUIS OBISPO, CA 93401-5252
(805) 266-0790
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
CA
Other
Enumeration date
07/23/2014
Last updated
07/23/2014
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