Individual
MS. CRYSTAL DUANE JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S.
Contact information
Practice address
401 E FRONT STREET, SUITE 139, TYLER, TX 75701-1608
(903) 570-8513
(903) 533-0673
Mailing address
814 S. BROADWAY AVE., TYLER, TX 75701
(903) 570-8513
(903) 533-0673
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
9187
TX
101YA0400X
Addiction (Substance Use Disorder) Counselor
0831-0991
TX
106H00000X
Marriage & Family Therapist
88
TX
Other
Enumeration date
01/19/2012
Last updated
01/19/2012
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