Individual
CRYSTAL REANEE KISSELBURGH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, LAC, LPCC
Contact information
Practice address
2956 NORTH AVE STE 1, GRAND JUNCTION, CO 81504-3919
(970) 208-1103
Mailing address
649 BROKEN SPOKE RD, GRAND JUNCTION, CO 81504-6981
(970) 779-7824
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
ACD.0001546
CO
101YM0800X
Mental Health Counselor
LPC.0026958
CO
Other
Enumeration date
10/23/2020
Last updated
04/20/2022
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