Doctor Name: | CRYSTALYN HORI-WILSON |
NPI Number: | 1043568744 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 8039386-6009 |
Business Practice Address: | 934 S Main St Layton, UT - 840417135 |
Business Phone Number: | 8017737060 |
Business Fax Number: | |
Mailing Address: | 934 S Main St, LAYTON |
State: | UT |
Postal Code: | 840417135 |
Phone Number: | 8017737060 |
Fax Number: | |
NPI Enumeration Date: | 08/28/2012 |
NPI Last Update Date: | 08/28/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | 8039386-6009 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | UT |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |