Individual
KRYSTAL MARIA VANBUREN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4318 BERKSHIRE ST, DETROIT, MI 48224-3502
(253) 392-9271
Mailing address
5267 CHATSWORTH ST, DETROIT, MI 48224-3210
(253) 392-9271
Taxonomy
Speciality
Code
Description
License number
State
103TH0004X
Health Psychologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
386983189
I DON'T HAVE A NP I NUMBER
MI
Enumeration date
04/24/2020
Last updated
04/24/2020
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