Individual
CRYSTA MICHELLE NILSSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPCMHSP
Contact information
Practice address
7000 JUANA DR, MILLINGTON, TN 38053-4062
(931) 231-0972
Mailing address
7000 JUANA DR, MILLINGTON, TN 38053-4062
(931) 231-0972
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
3205
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
Q041285
—
TN
Enumeration date
03/13/2018
Last updated
11/16/2022
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