Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225C00000X | Rehabilitation Counselor |
NPI | 1063062958 |
---|---|
Provider Name | Ms. Deyna Ann Cruz |
First Address | Las Vegas, NV 89156-5833 |
Second Address | Las Vegas, NV 89156-5833 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/09/2019 |
Last Update Date | 12/09/2019 |