Individual
CRYSTAL A JOHN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
9729 64TH RD, REGO PARK, NY 11374-2240
(718) 896-3400
(718) 459-5621
Mailing address
17224 133RD AVE APT 2G, JAMAICA, NY 11434-3901
(718) 949-7233
(718) 626-0690
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00244019
—
NY
Enumeration date
05/19/2008
Last updated
05/19/2008
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