Individual
CHRYSTAL STEPHANY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA,LPC
Contact information
Practice address
N7640 CTY RD WH, STE 200, FOND DU LAC, WI 54935-5493
(920) 933-3736
Mailing address
N7640 CTY RD WH STE 200, FOND DU LAC, WI 54937-2526
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
16445
WI
101YP2500X
Professional Counselor
Primary
6151-125
WI
Other
Enumeration date
12/11/2015
Last updated
10/11/2019
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