Provider Demographics
NPI:1164838728
Name:CRESPO, LUZ Y (MPSY)
Entity Type:Individual
Prefix:
First Name:LUZ
Middle Name:Y
Last Name:CRESPO
Suffix:
Gender:F
Credentials:MPSY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 CARR 787 APT /1301
Mailing Address - Street 2:RIVER GLANCE
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00727-6204
Mailing Address - Country:US
Mailing Address - Phone:787-397-1995
Mailing Address - Fax:
Practice Address - Street 1:FF3 STREET 11 4 TA SEC
Practice Address - Street 2:VILLA DEL REY
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725
Practice Address - Country:US
Practice Address - Phone:787-397-1995
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-03
Last Update Date:2014-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR5422103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling