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MR. CRYSTAL LOUISE KAVANAUGH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LPE (PROVISIONAL)

Contact information

Practice address
5905 FOREST PL, LITTLE ROCK, AR 72207-5244
(501) 666-4949
Mailing address
PO BOX 251970, LITTLE ROCK, AR 72225-1970
(501) 666-8686
(501) 660-6830

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
PROVISIONAL
AR

Other

Enumeration date
03/06/2007
Last updated
07/08/2007
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