Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YA0400X | Addiction Counselor (Substance Use Disorder) | ACC.0006911 | CO |
NPI | 1003242967 |
---|---|
Provider Name | Anna Cruz |
First Address | Greeley, CO 80631-9584 |
Second Address | Greeley, CO 80631-9586 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/09/2013 |
Last Update Date | 23/09/2013 |