Individual
CRYSTAL NICOLE PONCE DE LEON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1270 DORIS RD, AUBURN HILLS, MI 48326-2617
(248) 276-8000
Mailing address
5111 AUTO CLUB DR STE 112, DEARBORN, MI 48126-2684
(248) 276-8000
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
6802090292
MI
Other
Enumeration date
02/20/2019
Last updated
02/03/2026
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