Individual
MRS. CRYSTAL DACOSTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCMHC
Contact information
Practice address
148 COOLIDGE AVE, MANCHESTER, NH 03102-3493
(603) 689-7890
Mailing address
593 UNION ST APT 1, MANCHESTER, NH 03104-6132
(603) 479-2984
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
2832
NH
Other
Enumeration date
04/04/2024
Last updated
04/04/2024
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