Individual
CRYSTAL JUANITA CHRISTIAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1275 JAMES DRIVE, SUITE A ENTERPRISE BEHAVIORAL SERVICES, ENTERPRISE, AL 36330
(334) 393-9130
Mailing address
233 TRENT RD, ENTERPRISE, AL 36330-8785
(334) 393-1968
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
C1622A
AL
Other
Enumeration date
09/10/2009
Last updated
09/10/2009
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