Individual
MRS. CRYSTAL JOSEPHINE SUBOTICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.N.
Contact information
Practice address
22170 W 9 MILE RD, SOUTHFIELD, MI 48033-6007
(248) 372-6800
(248) 355-1402
Mailing address
22170 W 9 MILE RD, SOUTHFIELD, MI 48033-6007
(248) 372-6800
(248) 355-1402
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
4704151724
MI
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
4704151724
MI
Other
Enumeration date
02/07/2012
Last updated
03/02/2017
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