Provider Demographics
NPI:1821550146
Name:BELFORD, CRYSTAL H
Entity Type:Individual
Prefix:
First Name:CRYSTAL
Middle Name:H
Last Name:BELFORD
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 1:1229 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WEST PORTSMOUTH
Mailing Address - State:OH
Mailing Address - Zip Code:45663-5977
Mailing Address - Country:US
Mailing Address - Phone:740-821-5095
Mailing Address - Fax:
Practice Address - Street 1:4304 OLD SCIOTO TRL
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:OH
Practice Address - Zip Code:45662-6672
Practice Address - Country:US
Practice Address - Phone:740-351-9298
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-04
Last Update Date:2020-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator