Individual
MS. CRYSTINA LOUISE BLAZE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1417 LAS VEGAS BLVD N, LAS VEGAS, NV 89101-1115
(702) 385-3776
Mailing address
1417 LAS VEGAS BLVD N, LAS VEGAS, NV 89101-1115
(702) 385-3776
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
—
225400000X
Rehabilitation Practitioner
Primary
—
—
Other
Enumeration date
12/26/2014
Last updated
12/26/2014
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