Individual
CRYSTAL PORTILLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMHC
Contact information
Practice address
350 EL MOLINO BLVD, LAS CRUCES, NM 88005-2915
(575) 323-8900
(575) 267-6228
Mailing address
3003 RONNA DR, LAS CRUCES, NM 88001-7531
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
CMH0212221
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
18677037
—
NM
Enumeration date
10/07/2014
Last updated
07/20/2024
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