Organization
VETERANS AFFAIRS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WAYNE EUGENE CRYST LCDC (ADDICTION THERAPIST)
(903) 583-6411
Entity
Organization
Contact information
Practice address
1201 EAST 9TH STREET, BONHAM, TX 75418
(903) 583-6411
(903) 583-6687
Mailing address
1201 E 9TH ST, BONHAM, TX 75418-4059
(903) 583-6411
(903) 583-6687
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
08/31/2012
Last updated
08/31/2012
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