Individual
CRYSTAL MASON-DICKENS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
412 INGLESIDE AVE, EMPORIA, VA 23847-2320
(252) 578-8334
Mailing address
302 S RUSSELL ST, GASTON, NC 27832-9784
(252) 578-8334
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
13642
VA
Other
Enumeration date
08/18/2025
Last updated
08/18/2025
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