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General NPI Number Information
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NPI Number | 1043031271
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Entity Type | Individual
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Provider Name | DEBRA NICOLE CRYSELL MS, ALC
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Gender | Female
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Dates
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Enumeration Date | 10/21/2024
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Last Update Date | 10/21/2024
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Provider Practice Location Address
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Address Line | 2277 DAMASCUS RD
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City | HONORAVILLE
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State | AL
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Zip | 36042-5627
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Country | US
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Telephone | 334-437-3983
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Fax |
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Provider Business Mailing Address
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Address Line | 430 GREENVILLE BYP
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City | GREENVILLE
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State | AL
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Zip | 36037-3729
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Country | US
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Telephone | 334-437-3983
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | ALC05075
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License Number State | AL
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | ALC05075
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License Number State | AL
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