Individual
MRS. CRYSTAL MONICA WISCHHUSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMSW-R
Contact information
Practice address
196 BELLEVIEW AVE, CENTER MORICHES, NY 11934-3729
(631) 503-1728
Mailing address
196 BELLEVIEW AVE, CENTER MORICHES, NY 11934-3729
(631) 294-6749
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
72 088114
NY
Other
Enumeration date
05/29/2014
Last updated
09/25/2020
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