Provider Demographics
NPI:1508634213
Name:ZAMORA, KRYSTAL (LMSW, CSW INTERN)
Entity Type:Individual
Prefix:MS
First Name:KRYSTAL
Middle Name:
Last Name:ZAMORA
Suffix:
Gender:F
Credentials:LMSW, CSW INTERN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4538 W CRAIG RD STE 290
Mailing Address - Street 2:
Mailing Address - City:N LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89032-2511
Mailing Address - Country:US
Mailing Address - Phone:702-486-0012
Mailing Address - Fax:
Practice Address - Street 1:4538 W CRAIG RD STE 290
Practice Address - Street 2:
Practice Address - City:N LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89032-2511
Practice Address - Country:US
Practice Address - Phone:702-486-0012
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-13
Last Update Date:2023-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health