Most Relevant Information
Provider Data
| NPI Number: | 1003408527 |
| Provider Name: | XENA IMARI CRESPIN LMSW |
| Entity Type: | Individual |
| Taxonomy Code: | 104100000X |
| Specialty: | Social Worker |
| License Number: | X-11822 |
Most Important Dates
| Enumeration Date: | 02/05/2021 |
| Last Updated: | 02/05/2021 |
Provider Practice Location
2528 RIDGE RUNNER RD
LAS VEGAS
NM
877014971
Practice Location Phone/Fax
| Phone: | 5054252622 |
| Fax: |
Provider Mailing Location
2528 RIDGE RUNNER RD
LAS VEGAS
NM
877014971
Provider Mailing Phone/Fax
| Phone: | 5054252622 |
| Fax: |