Individual
KRYSTAL LAUREN RAQUET
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
10410 DOHERTY SPG, SAN ANTONIO, TX 78255-1041
(210) 395-4520
(210) 395-4521
Mailing address
10410 DOHERTY SPG, SAN ANTONIO, TX 78255-1041
(210) 395-4520
(210) 395-4521
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
1053028
TX
Other
Enumeration date
03/04/2019
Last updated
05/14/2026
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