Individual
CRYSTAL RIOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, LMFT
Contact information
Practice address
400 N EASTERN AVE, MOORE, OK 73160-5833
(405) 659-5858
Mailing address
1925 METLOCK LN, MOORE, OK 73160-5639
(405) 659-5858
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
1159
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200389120 C
—
OK
Enumeration date
04/20/2010
Last updated
06/16/2015
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