Individual
CHRYSTAL L SHOUP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2911 DIXWELL AVE STE 5, HAMDEN, CT 06518-3195
(860) 987-9704
Mailing address
50 BROOKSIDE RD, WATERBURY, CT 06708-1402
(860) 987-9704
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
Primary
—
—
Other
Enumeration date
04/14/2015
Last updated
08/09/2024
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