Most Relevant Information
Provider Data
| NPI Number: | 1003541335 |
| Provider Name: | CRYSTAL SHARRELL DORSEY |
| Entity Type: | Individual |
| Taxonomy Code: | 101YM0800X |
| Specialty: | Counselor |
| License Number: | LGP12636 |
Most Important Dates
| Enumeration Date: | 07/20/2022 |
| Last Updated: | 07/20/2022 |
Provider Practice Location
2700 WASHINGTON AVE
HALETHORPE
MD
212273115
Practice Location Phone/Fax
| Phone: | 6676003900 |
| Fax: |
Provider Mailing Location
4264 MARY RIDGE DR
RANDALLSTOWN
MD
211334319
Provider Mailing Phone/Fax
| Phone: | 4438311284 |
| Fax: |