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NPI Code Detail

MEDICARE: CRYSTAL MURRAY MENTAL HEALTH SPECIA

MEDICARE: CRYSTAL MURRAY MENTAL HEALTH SPECIA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101Y00000XCounselorLA

General Provider Information

NPI Number : 1629435698
Entity Type Code : Individual
Provider Name (Legal Business Name) : CRYSTAL MURRAY MENTAL HEALTH SPECIA
Provider Business Mailing Address
First Line : 5925 GREENWELL SPRINGS RD
Second Line :
City : BATON ROUGE
State : LA
Zip : 70806-1620
Country : US
Telephone Number : 225-926-7911
Fax Number :
Provider Business Practice Location Address
First Line : 5925 GREENWELL SPRINGS RD
Second Line :
City : BATON ROUGE
State : LA
Zip : 70806-1620
Country : US
Telephone Number : 225-926-7911
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/21/2016
Last Update Date : 01/21/2016

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Directions to “ CRYSTAL MURRAY MENTAL HEALTH SPECIA” Practice Location

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