| Doctor Name: | MRS. CRYSTAL JOANN MOSBY |
| NPI Number: | 1033415062 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | L.L.P.C. |
| License Number: | 6401006613 |
| Business Practice Address: | 27601 Morningside Plz Lathrup Village, MI - 480763266 |
| Business Phone Number: | 3137066306 |
| Business Fax Number: | |
| Mailing Address: | 27601 Morningside Plz, LATHRUP VILLAGE |
| State: | MI |
| Postal Code: | 480763266 |
| Phone Number: | 3137066306 |
| Fax Number: | |
| NPI Enumeration Date: | 02/09/2011 |
| NPI Last Update Date: | 02/09/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | 6401006613 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MI |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |