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Individual

KRISTAL BOUNDS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCDC

Contact information

Practice address
950 N 4TH ST, LONGVIEW, TX 75601-5436
(903) 758-2471
Mailing address
950 N 4TH ST, LONGVIEW, TX 75601-5436
(903) 753-9843

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
10494
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
10494
LCDC
TX
Enumeration date
06/28/2016
Last updated
06/27/2022
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