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CRYSTAL AMBER LYNN AMICK

>> Community Health Worker >> Other Service Providers

Registrant NPI Number: 1891115184

Individual Registrant:
 CRYSTAL AMBER LYNN AMICK 
Gender: F
Sole Proprietor

Location and contact information for practice:
16519 VICTOR ST STE 421  VICTORVILLE, CA 92395-3935 US
Tel: 442-242-4325  Fax: --

Contact information for business:
13083 HILCORTE LN  VICTORVILLE, CA 92394-3704 US
Tel: 760-646-5410  Fax: --

Registration Information:
NPI: 1891115184
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
N172V00000XOther Service Providers
Community Health Worker
N390200000XStudent
Organized Health Care Education/Training Program
Y106H00000XBehavioral Health & Social Service Providers
Marriage & Family Therapist
CALMFT107398

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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