Individual
CRYSTAL LEE KRISKO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
21000 EDUCATION CT, BROADLANDS, VA 20148-5526
(703) 431-3289
Mailing address
21000 EDUCATION CT, BROADLANDS, VA 20148-5526
(703) 431-3289
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
0119001932
VA
Other
Enumeration date
04/02/2018
Last updated
04/02/2018
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