Individual
CRYSTAL RAVILLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
15 4TH ST, MALONE, NY 12953-1340
(518) 319-0173
Mailing address
3 STONE RD, MALONE, NY 12953-3431
(518) 319-0173
Taxonomy
Speciality
Code
Description
License number
State
163WP0809X
Adult Psychiatric/Mental Health Registered Nurse
Primary
83943601
NY
Other
Enumeration date
09/19/2014
Last updated
08/22/2022
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