Individual
CRYSTAL GAIL BORDERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN, LCDC III
Contact information
Practice address
411 COURT ST, PORTSMOUTH, OH 45662-3932
(740) 354-3829
(740) 353-3083
Mailing address
923 FINDLAY ST, PORTSMOUTH, OH 45662-4148
(740) 354-3829
(740) 353-3083
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LCDCIII.161510
OH
164W00000X
Licensed Practical Nurse
150837.MEDS-IV
OH
Other
Enumeration date
03/06/2017
Last updated
11/29/2017
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