Individual
CRYSTAL RIVERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD, LP
Contact information
Practice address
11090 183RD CIR NW STE C, ELK RIVER, MN 55330-2884
(763) 777-1381
Mailing address
4700 78TH ST, URBANDALE, IA 50322-1031
(919) 357-8006
(515) 335-0247
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
LP6956
MN
103TC0700X
Clinical Psychologist
101246
IA
Other
Enumeration date
01/15/2021
Last updated
03/04/2025
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