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NPI Code Detail

MEDICARE: MRS. KRISTIN MUNIZ LCSW, CSOTP

MEDICARE: MRS. KRISTIN MUNIZ LCSW, CSOTP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social WorkerSWB-2023-0021NM

General Provider Information

NPI Number : 1811481179
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. KRISTIN MUNIZ LCSW, CSOTP
Provider Business Mailing Address
First Line : 1350 MANZANITA CT SE
Second Line :
City : RIO RANCHO
State : NM
Zip : 87124-2819
Country : US
Telephone Number : 575-418-3597
Fax Number :
Provider Business Practice Location Address
First Line : 1600 SAN PEDRO DR NE
Second Line :
City : ALBUQUERQUE
State : NM
Zip : 87110-6734
Country : US
Telephone Number : 888-771-1531
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/20/2018
Last Update Date : 05/19/2023

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