Individual
JENNIFER CRISCUOLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4001 OFFICE COURT DR STE 603, SANTA FE, NM 87507-4905
(505) 830-1871
Mailing address
2612 TEXAS ST NE, ALBUQUERQUE, NM 87110-4684
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
X-11021
NM
Other
Enumeration date
08/27/2019
Last updated
08/27/2019
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