Provider Demographics
NPI:1841883329
Name:SCIARINI, CRYSTAL LYNN (ND, LPC-A)
Entity type:Individual
Prefix:
First Name:CRYSTAL
Middle Name:LYNN
Last Name:SCIARINI
Suffix:
Gender:F
Credentials:ND, LPC-A
Other - Prefix:
Other - First Name:CRYSTAL
Other - Middle Name:
Other - Last Name:KEENER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1115 RED BIRD LN
Mailing Address - Street 2:
Mailing Address - City:GRANBURY
Mailing Address - State:TX
Mailing Address - Zip Code:76048-2561
Mailing Address - Country:US
Mailing Address - Phone:817-940-7122
Mailing Address - Fax:
Practice Address - Street 1:5310 E US HIGHWAY 377 STE 200
Practice Address - Street 2:
Practice Address - City:GRANBURY
Practice Address - State:TX
Practice Address - Zip Code:76049-7849
Practice Address - Country:US
Practice Address - Phone:817-940-7122
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-16
Last Update Date:2024-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
175F00000X
TX96626101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No175F00000XOther Service ProvidersNaturopath