Individual
CRYSTINA WELLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1602 W WALNUT ST, MARION, IL 62959-1310
(618) 364-2504
Mailing address
1602 W WALNUT ST, MARION, IL 62959-1310
(618) 364-2504
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
12918791-6004
UT
101YP2500X
Professional Counselor
Primary
178014887
IL
101YP2500X
Professional Counselor
Primary
180012737
IL
Other
Enumeration date
05/09/2019
Last updated
04/02/2026
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