Individual
CRYSTAL STAR LYGHT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ACLC
Contact information
Practice address
1203 US HIGHWAY 2 W SIDE, KALISPELL, MT 59901-6071
(406) 314-6565
(406) 314-6566
Mailing address
PO BOX 1269, LIBBY, MT 59923-1269
(406) 300-8302
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
BBH-ACLC-LIC-78912
MT
Other
Enumeration date
06/09/2025
Last updated
06/09/2025
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