Krystle Starr Dewberry
Counselor in Barstow, CA. Individual provider (NPI-1).
NPI number1164071668
StatusActive
Last updated in NPPESJun 6, 2022
Details
- NPI
- 1164071668
- Entity type
- Individual (NPI-1)
- Name
- Krystle Starr Dewberry
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Sep 6, 2019
- Certification date
- Jun 5, 2022
- Last updated
- Jun 6, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101Y00000X | Counselor | – | – | Yes |
Practice location
222 E Main St # 117Barstow, CA 92311-2361
Phone 760-255-1496 · Fax 760-255-2542
Mailing address
222 E Main St # 117Barstow, CA 92311-2361
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