Provider Information for 1083382964
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CRYSTAL ELIZABETH GARCIA LICSW
Sex: Female
NPI: 1083382964
Last Updated: 2021-09-03
Certification Date: 2021-09-03
Certification Date: 2021-09-03
Details
| Name | Value | ||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NPI | 1083382964 | ||||||||||||||
| Enumeration Date | 2021-09-03 | ||||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||||
| Sole Proprietor | YES | ||||||||||||||
| Status | Active | ||||||||||||||
| Mailing Address | PO BOX 8713 LACEY, WA 98509-8713 United States Phone: 360-790-8602 | Fax:360-925-3037 | ||||||||||||||
| Primary Practice Address | 4932 SISKIYOU LOOP SE OLYMPIA, WA 98501-7910 United States Phone: 360-790-8602 | Fax:360-925-3037 | ||||||||||||||
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