Individual
CRYSTAL RAIN PENA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
138 MOUNTAINDALE RD, YONKERS, NY 10710-3510
(646) 483-8180
Mailing address
138 MOUNTAINDALE RD, YONKERS, NY 10710-3510
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
605472233
—
NY
Enumeration date
10/17/2024
Last updated
10/17/2024
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