Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TR0400X | Rehabilitation Psychologist |
NPI | 1356602494 |
---|---|
Provider Name | Elizabeth Cruz |
First Address | Sanford, FL 32771-4415 |
Second Address | Winter Park, FL 32792-3205 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/06/2012 |
Last Update Date | 05/06/2012 |