Doctor Name: | CRYSTAL Z MCLEAN |
NPI Number: | 1003054636 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | |
Business Practice Address: | 820 N Plankinton Ave Milwaukee, WI - 532031802 |
Business Phone Number: | 4142251606 |
Business Fax Number: | 4142236800 |
Mailing Address: | 820 N Plankinton Ave, MILWAUKEE |
State: | WI |
Postal Code: | 532031802 |
Phone Number: | 4142251606 |
Fax Number: | 4142236800 |
NPI Enumeration Date: | 02/04/2009 |
NPI Last Update Date: | 02/04/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |