Individual
CHRYSTAL CHARLES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
103 W BROAD ST, STAMFORD, CT 06902-3713
(201) 111-1111
Mailing address
103 W BROAD ST, STAMFORD, CT 06902-3713
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
02/27/2024
Last updated
03/23/2026
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