Individual
MRS. CRYSTAL MARIE KINMON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCDC-I
Contact information
Practice address
5201 MCCART AVE STE H, FORT WORTH, TX 76115-3700
(817) 207-8700
Mailing address
5201 MCCART AVE STE H, FORT WORTH, TX 76115-3700
(817) 207-8700
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
51823
TX
Other
Enumeration date
04/06/2021
Last updated
04/06/2021
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