Provider Demographics
NPI:1942557335
Name:HOFFMAN FAULKENBERRY, CRYSTAL ROSE (LPC)
Entity Type:Individual
Prefix:
First Name:CRYSTAL
Middle Name:ROSE
Last Name:HOFFMAN FAULKENBERRY
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:4300 S HARVARD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74135-2608
Mailing Address - Country:US
Mailing Address - Phone:918-585-3163
Mailing Address - Fax:918-584-1835
Practice Address - Street 1:6216 S LEWIS AVE STE 180
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74136-1077
Practice Address - Country:US
Practice Address - Phone:918-960-7852
Practice Address - Fax:539-664-5738
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-06
Last Update Date:2024-03-21
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health