Individual
MS. CRYSTAL A MCKINNISS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
601 S EDWIN C MOSES BLVD, SAMARITAN BEHAVIORAL HEALTH INC.,, DAYTON, OH 45417-3424
(937) 734-8333
Mailing address
601 S EDWIN C MOSES BLVD, SAMARITAN BEHAVIORAL HEALTH INC, 4TH FLOOR NW BLDG, DAYTON, OH 45417-3424
(937) 734-8333
(937) 734-4343
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
RN.507286
OH
167G00000X
Licensed Psychiatric Technician
PN.122329-M-IV
OH
Other
Enumeration date
02/24/2016
Last updated
05/17/2022
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