Individual
CRYSTAL IRISH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LADAC
Contact information
Practice address
39 FOGG FARM RD, WHITE RIVER JCT, VT 05088-0508
(802) 295-1311
Mailing address
PO BOX G, RANDOLPH, VT 05060-0167
(802) 728-4466
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
151.0134105
VT
Other
Enumeration date
01/21/2021
Last updated
01/21/2021
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