Provider Information for 1386905305
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CRYSTAL WILLIAMS M.A., Ed.D
Sex: Female
NPI: 1386905305
Last Updated: 2021-10-13
Certification Date: 2021-10-13
Certification Date: 2021-10-13
Details
| Name | Value | ||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NPI | 1386905305 | ||||||||||||||
| Enumeration Date | 2012-06-06 | ||||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||||
| Sole Proprietor | YES | ||||||||||||||
| Status | Active | ||||||||||||||
| Mailing Address | 438 S MAPLE DR APT 4 BEVERLY HILLS, CA 90212-4798 United States Phone: 310-386-6511 | Fax: | ||||||||||||||
| Primary Practice Address | 438 S MAPLE DR APT 4 BEVERLY HILLS, CA 90212 United States Phone: 310-386-6511 | Fax: | ||||||||||||||
| Secondary Practice Address(es) | 439 S HAMEL RD | ||||||||||||||
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