Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106E00000X | Assistant Behavior Analyst | 18-51326 | TX |
NPI | 1134723273 |
---|---|
Provider Name | Alexandria Cruz |
First Address | San Antonio, TX 78218 |
Second Address | San Antonio, TX 78218 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/11/2020 |
Last Update Date | 30/11/2020 |