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General NPI Number Information
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NPI Number | 1972834588
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Entity Type | Individual
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Provider Name | CRISTAL NICOLE BROOM
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Gender | Female
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Dates
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Enumeration Date | 01/21/2010
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Last Update Date | 01/21/2010
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Provider Practice Location Address
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Address Line | 38 ROSSCRAGGON RD SUITE 38 C
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City | ASHEVILLE
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State | NC
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Zip | 28803-1163
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Country | US
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Telephone | 828-654-7700
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Fax |
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Provider Business Mailing Address
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Address Line | 1420 ASHEVILLE SPRINGS CIR
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City | ASHEVILLE
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State | NC
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Zip | 28806-5528
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Country | US
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Telephone | 803-404-9423
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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 |
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License Number State |
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