Individual
CRYSTAL LYNN MALDONADO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
512 E 24TH ST, TISHOMINGO, OK 73460-3214
(580) 371-3672
Mailing address
512 E 24TH ST, TISHOMINGO, OK 73460-3214
(580) 371-3672
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
08/10/2017
Last updated
08/10/2017
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