Individual
MISS CRYSTAL RAYNE FULTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC, LCDC
Contact information
Practice address
1224 SOUTHRIDGE, SALADO, TX 76571-5801
(972) 983-9577
Mailing address
1224 SOUTHRIDGE, SALADO, TX 76571-5801
(972) 983-9577
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
88978
TX
101YA0400X
Addiction (Substance Use Disorder) Counselor
15716
TX
Other
Enumeration date
07/30/2024
Last updated
07/30/2024
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