Provider Demographics
NPI:1336893585
Name:HUMBLE, CRYSTAL
Entity type:Individual
Prefix:DR
First Name:CRYSTAL
Middle Name:
Last Name:HUMBLE
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 1:1814 COTTON MILL CT
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77406-2101
Mailing Address - Country:US
Mailing Address - Phone:281-238-4344
Mailing Address - Fax:
Practice Address - Street 1:25722 KINGSLAND BLVD STE 112
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77494-2641
Practice Address - Country:US
Practice Address - Phone:832-934-9036
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-07
Last Update Date:2022-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX87521101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor