Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YM0800X | Mental Health Counselor | NC | |
N | 103TA0400X | Addiction Psychologist (Substance Use Disorder) | NC | |
N | 103TA0700X | Adult Development & Aging Psychologist | NC | |
N | 103TB0200X | Cognitive & Behavioral Psychologist | NC | |
N | 103TC2200X | Clinical Child & Adolescent Psychologist | NC | |
N | 103TM1800X | Intellectual & Developmental Disabilities | NC | |
N | 104100000X | Social Worker | NC |
NPI | 1235311424 |
---|---|
Provider Name | Mrs. Crystal Graham Bell |
First Address | Goldsboro, NC 27534-8301 |
Second Address | Goldsboro, NC 27534-8301 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/11/2007 |
Last Update Date | 29/11/2007 |