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Individual

CRYSTAL STONE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1081 3RD AVE SW STE 7, CARMEL, IN 46032-7500
(317) 564-0934
Mailing address
1389 W 86TH ST # 170, INDIANAPOLIS, IN 46260-2101
(317) 564-0934

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary

Other

Enumeration date
09/16/2020
Last updated
09/16/2020
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