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NPI Code Detail

MEDICARE: CRYSTAL D DEETS PLPC

MEDICARE: CRYSTAL D DEETS PLPC
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
1101YP2500XProfessional Counselor2009032459MO

General Provider Information

NPI Number : 1982931697
Entity Type Code : Individual
Provider Name (Legal Business Name) : CRYSTAL D DEETS PLPC
Provider Business Mailing Address
First Line : 724 N 22ND ST
Second Line :
City : SAINT JOSEPH
State : MO
Zip : 64506-2604
Country : US
Telephone Number : 816-236-2398
Fax Number : 816-236-2464
Provider Business Practice Location Address
First Line : 724 N 22ND ST
Second Line :
City : SAINT JOSEPH
State : MO
Zip : 64506-2604
Country : US
Telephone Number : 816-236-2398
Fax Number : 816-236-2464
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/17/2009
Last Update Date : 11/17/2009

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Directions to “ CRYSTAL D DEETS PLPC” Practice Location

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