Provider Demographics
NPI:1194001792
Name:FESSLER, CRYSTAL N (LPC-S, RPT-S)
Entity Type:Individual
Prefix:
First Name:CRYSTAL
Middle Name:N
Last Name:FESSLER
Suffix:
Gender:F
Credentials:LPC-S, RPT-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:605 E BOONE ST
Mailing Address - Street 2:
Mailing Address - City:TAHLEQUAH
Mailing Address - State:OK
Mailing Address - Zip Code:74464-4126
Mailing Address - Country:US
Mailing Address - Phone:918-718-1396
Mailing Address - Fax:
Practice Address - Street 1:605 E BOONE ST
Practice Address - Street 2:
Practice Address - City:TAHLEQUAH
Practice Address - State:OK
Practice Address - Zip Code:74464-4126
Practice Address - Country:US
Practice Address - Phone:918-718-1396
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-26
Last Update Date:2021-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor