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General NPI Number Information
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NPI Number | 1447810023
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Entity Type | Individual
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Provider Name | CRYSTAL CISNEROS LMFT-QS
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Gender | Female
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Dates
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Enumeration Date | 06/17/2019
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Last Update Date | 02/08/2025
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Provider Practice Location Address
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Address Line | 11200 SW 8TH ST SHC 270
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City | MIAMI
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State | FL
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Zip | 33199-1436
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Country | US
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Telephone | 305-348-2277
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Fax |
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Provider Business Mailing Address
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Address Line | 9940 NW 9TH STREET CIR APT 101
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City | MIAMI
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State | FL
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Zip | 33172-5106
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Country | US
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Telephone | 786-999-2266
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | IMT2461
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | MT3986
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License Number State | FL
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