Individual
KRYSTAL EBBINGHAUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3257 W 20TH ST, GREELEY, CO 80634-6550
(970) 672-4667
Mailing address
4311 W 17TH ST, GREELEY, CO 80634-3329
(631) 882-5552
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
175T00000X
Peer Specialist
—
—
251S00000X
Community/Behavioral Health Agency
—
—
Other
Enumeration date
02/23/2023
Last updated
02/23/2023
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