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1831607506
KRYSTINA RENAE CARVISO
GALLUP, NM
NPI
1831607506
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
251B00000X Case Management
Additional Taxonomies
106S00000X Behavior Technician
Enumeration Date
2018-01-17
Last Update Date
2022-11-15
Business Address
KRYSTINA RENAE CARVISO
2025 E AZTEC AVE
GALLUP, NM 87301-4803
Phone number: 505-863-3828
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Mailing Address
KRYSTINA RENAE CARVISO
PO BOX 594
WINDOW ROCK, AZ 86515-0594
Phone number: 602-525-5310
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