Provider Demographics
NPI:1982462305
Name:CRESPO, MARIA ROSARIO (LMFT 4862)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:ROSARIO
Last Name:CRESPO
Suffix:
Gender:F
Credentials:LMFT 4862
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2237 NW 171ST TER
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33028-2053
Mailing Address - Country:US
Mailing Address - Phone:786-317-2583
Mailing Address - Fax:
Practice Address - Street 1:2237 NW 171ST TER
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33028-2053
Practice Address - Country:US
Practice Address - Phone:786-317-2583
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-11
Last Update Date:2024-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL4862106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist