Individual
CRYSTAL WYETH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
10473 OLD HAMMOND HWY, BATON ROUGE, LA 70816-8264
(225) 924-1910
Mailing address
10473 OLD HAMMOND HWY, BATON ROUGE, LA 70816-8264
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
07/16/2018
Last updated
07/16/2018
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