Individual
MS. CRYSTAL MARIE BAZEMORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CDCA
Contact information
Practice address
1755 LANCASTER AVE, REYNOLDSBURG, OH 43068-3108
(614) 610-9023
Mailing address
5664 DASHSHUND CT, COLUMBUS, OH 43232-7506
(614) 962-0842
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
168708
OH
Other
Enumeration date
11/04/2019
Last updated
11/04/2019
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