Doctor Name: | MR. JUSTIN LEE CRYMES |
NPI Number: | 1811918832 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MA |
License Number: | |
Business Practice Address: | 1813 Cecil Webb Place Boys Ranch, FL - 320641550 |
Business Phone Number: | 3868425555 |
Business Fax Number: | |
Mailing Address: | Po Box 2000, BOYS RANCH |
State: | FL |
Postal Code: | 320641550 |
Phone Number: | 3868425555 |
Fax Number: | |
NPI Enumeration Date: | 07/22/2006 |
NPI Last Update Date: | 12/02/2010 |
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: |