Individual
CRYSTAL PAUL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCPC
Contact information
Practice address
531 BRYDEN AVE, LEWISTON, ID 83501-0308
(208) 798-1646
Mailing address
531 BRYDEN AVE, LEWISTON, ID 83501-0308
(208) 798-1646
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LCPC-5674
ID
Other
Enumeration date
04/12/2012
Last updated
11/10/2014
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