Individual
CRYSTAL M STALLWORTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
330 FARM PATH, ROSWELL, GA 30075-4219
(404) 997-0167
Mailing address
330 FARM PATH, ROSWELL, GA 30075-4219
(404) 997-0167
Taxonomy
Speciality
Code
Description
License number
State
171400000X
Health & Wellness Coach
—
—
174200000X
Meals Provider
—
—
251E00000X
Home Health Agency
Primary
—
—
Other
Enumeration date
08/30/2021
Last updated
08/30/2021
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