Individual
MISS CRYSTAL WYTENUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, LPC
Contact information
Practice address
567 MORRIS AVE, ELIZABETH, NJ 07208-1985
(908) 355-7200
Mailing address
567 MORRIS AVE, ELIZABETH, NJ 07208-1985
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
37PC00474500
NJ
Other
Enumeration date
10/18/2013
Last updated
10/18/2013
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