Individual
CRYSTAL WHITESIDES KIRKLAND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2505 COURT DR, GASTONIA, NC 28054-2140
(704) 534-7950
Mailing address
2505 COURT DR, GASTONIA, NC 28054-2140
(704) 534-7950
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
22751
NC
Other
Enumeration date
10/24/2018
Last updated
10/24/2018
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