Provider Demographics
NPI:1811481179
Name:MUNIZ, KRISTIN (LCSW, CSOTP)
Entity type:Individual
Prefix:MRS
First Name:KRISTIN
Middle Name:
Last Name:MUNIZ
Suffix:
Gender:F
Credentials:LCSW, CSOTP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1350 MANZANITA CT SE
Mailing Address - Street 2:
Mailing Address - City:RIO RANCHO
Mailing Address - State:NM
Mailing Address - Zip Code:87124-2819
Mailing Address - Country:US
Mailing Address - Phone:575-418-3597
Mailing Address - Fax:
Practice Address - Street 1:1600 SAN PEDRO DR NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87110-6734
Practice Address - Country:US
Practice Address - Phone:888-771-1531
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-20
Last Update Date:2023-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMSWB-2023-00211041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical