Provider Demographics
NPI:1114185378
Name:EATMAN, CRYSTEL (MSW)
Entity Type:Individual
Prefix:
First Name:CRYSTEL
Middle Name:
Last Name:EATMAN
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1722 N COLLEGE AVE STE C
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72703-2640
Mailing Address - Country:US
Mailing Address - Phone:502-762-2672
Mailing Address - Fax:
Practice Address - Street 1:1722 N COLLEGE AVE STE C
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:AR
Practice Address - Zip Code:72703-2640
Practice Address - Country:US
Practice Address - Phone:502-762-2672
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-23
Last Update Date:2008-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker