Provider Demographics
NPI:1518346501
Name:GERINGER, CRYSTAL LEE
Entity Type:Individual
Prefix:
First Name:CRYSTAL
Middle Name:LEE
Last Name:GERINGER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1532 FOX RUN RD
Mailing Address - Street 2:
Mailing Address - City:CHEYENNE
Mailing Address - State:WY
Mailing Address - Zip Code:82009-8390
Mailing Address - Country:US
Mailing Address - Phone:307-631-8649
Mailing Address - Fax:
Practice Address - Street 1:1532 FOX RUN RD
Practice Address - Street 2:
Practice Address - City:CHEYENNE
Practice Address - State:WY
Practice Address - Zip Code:82009-8390
Practice Address - Country:US
Practice Address - Phone:307-631-8649
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-22
Last Update Date:2015-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
No172V00000XOther Service ProvidersCommunity Health Worker