Individual
CRYSTAL J TORTALITA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
85 WEST HWY 22, SANTO DOMINGO PUEBLO, NM 87052
(505) 465-3060
(505) 318-1079
Mailing address
PO BOX 340, SANTO DOMINGO PUEBLO, NM 87052-0340
(505) 465-3060
(505) 318-1079
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
04/17/2024
Last updated
04/17/2024
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