Provider Demographics
NPI:1467749002
Name:MALONE, CRYSTLE SYON'TZE (MS, PBSS)
Entity type:Individual
Prefix:MS
First Name:CRYSTLE
Middle Name:SYON'TZE
Last Name:MALONE
Suffix:
Gender:F
Credentials:MS, PBSS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2998 SMACKOVER HWY
Mailing Address - Street 2:
Mailing Address - City:EL DORADO
Mailing Address - State:AR
Mailing Address - Zip Code:71730-8366
Mailing Address - Country:US
Mailing Address - Phone:870-440-7884
Mailing Address - Fax:
Practice Address - Street 1:2998 SMACKOVER HWY
Practice Address - Street 2:
Practice Address - City:EL DORADO
Practice Address - State:AR
Practice Address - Zip Code:71730-8366
Practice Address - Country:US
Practice Address - Phone:870-440-7884
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-04
Last Update Date:2024-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator