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Individual

CRYSTAL DENNETT BOULWARE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
207 BROAD ST, WICHITA FALLS, TX 76301-2219
(972) 800-6986
Mailing address
207 BROAD ST, WICHITA FALLS, TX 76301-2219
(972) 800-6986

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
11018
TX

Other

Enumeration date
03/09/2023
Last updated
03/09/2023
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