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Individual

MRS. CRYSTAL MARIE DAVIS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MA, LLPC

Contact information

Practice address
3537 FORT ST, WYANDOTTE, MI 48192-6315
(734) 818-9270
Mailing address
3537 FORT ST, WYANDOTTE, MI 48192-6315
(734) 818-9270

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
6401014693
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
SA0580017
MI
Enumeration date
10/02/2012
Last updated
07/19/2023
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