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General NPI Number Information
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NPI Number | 1700744026
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Entity Type | Individual
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Provider Name | CRYSTAL R PLUMB
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Gender | Female
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Dates
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Enumeration Date | 01/14/2026
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Last Update Date | 01/14/2026
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Provider Practice Location Address
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Address Line | 446 N WESTHILL BLVD STE A
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City | APPLETON
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State | WI
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Zip | 54914-6532
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Country | US
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Telephone | 877-300-9101
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Fax |
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Provider Business Mailing Address
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Address Line | 37 19TH ST
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City | CLINTONVILLE
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State | WI
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Zip | 54929-1131
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Country | US
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Telephone | 715-250-0675
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 8855-226
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License Number State | WI
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