Individual
CRYSTAL KIM COPELAND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
8658 AITKEN AVE, WHITESBORO, NY 13492-2609
(315) 570-5187
Mailing address
1026 ONTARIO ST, UTICA, NY 13501-2744
(315) 570-5187
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
109837-01
NY
Other
Enumeration date
12/08/2021
Last updated
12/08/2021
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