Individual
CRYSTAL DENISE PISANA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
406 CAMBRIDGE AVE, HAGERMAN, NM 88232-9610
(575) 752-0242
Mailing address
2402 CARVER DRIVE, ROSWELL, NM 88203
(575) 910-5004
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
X-12161
NM
Other
Enumeration date
11/26/2021
Last updated
11/26/2021
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