Individual
CRYSTAL DAWN STATOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
970 LILA AVE, MILFORD, OH 45150-1683
(513) 201-5440
Mailing address
115 LYNNVIEW DR, MASON, OH 45040-1819
(518) 903-0537
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
C.2406232
OH
Other
Enumeration date
06/26/2024
Last updated
06/26/2024
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