Provider Demographics
NPI:1033970884
Name:CRISPINO, SARA HUNT (LAC)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:HUNT
Last Name:CRISPINO
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1001 E 62ND AVE UNIT 1781
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80216-1267
Mailing Address - Country:US
Mailing Address - Phone:303-356-6139
Mailing Address - Fax:
Practice Address - Street 1:1245 DAHLIA ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80220-2448
Practice Address - Country:US
Practice Address - Phone:303-356-6139
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-18
Last Update Date:2024-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0002820171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist