Provider Demographics
NPI:1205503497
Name:SEIA, CRISSEL (MS)
Entity type:Individual
Prefix:
First Name:CRISSEL
Middle Name:
Last Name:SEIA
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:CRISSEL
Other - Middle Name:
Other - Last Name:NEVAREZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS
Mailing Address - Street 1:1708 SAWYER WAY APT 279
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80915-2015
Mailing Address - Country:US
Mailing Address - Phone:847-361-2172
Mailing Address - Fax:
Practice Address - Street 1:6845 CAMPUS DR STE 100
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80920-3107
Practice Address - Country:US
Practice Address - Phone:719-822-0900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-25
Last Update Date:2023-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician