Provider Demographics
NPI:1396623492
Name:SANTANA GUZMAN, CRISTAL ALTAGRACIA (MA)
Entity type:Individual
Prefix:
First Name:CRISTAL
Middle Name:ALTAGRACIA
Last Name:SANTANA GUZMAN
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24618 MEMPHIS AVE
Mailing Address - Street 2:
Mailing Address - City:ROSEDALE
Mailing Address - State:NY
Mailing Address - Zip Code:11422-2151
Mailing Address - Country:US
Mailing Address - Phone:774-388-4383
Mailing Address - Fax:
Practice Address - Street 1:100 MERRIMACK ST STE 205
Practice Address - Street 2:
Practice Address - City:LOWELL
Practice Address - State:MA
Practice Address - Zip Code:01852-1707
Practice Address - Country:US
Practice Address - Phone:774-388-4383
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-26
Last Update Date:2025-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor