Individual
LISA COURTNEY CRYSTAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MED, ATR
Contact information
Practice address
1669 W MAPLE RD, BIRMINGHAM, MI 48009-1230
(248) 646-4480
Mailing address
1617 HUNTWOOD PARK CT, WEST BLOOMFIELD, MI 48324
(248) 360-8441
Taxonomy
Speciality
Code
Description
License number
State
221700000X
Art Therapist
Primary
—
—
Other
Enumeration date
10/09/2009
Last updated
10/09/2009
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