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Individual
MS. SUSAN DE LA CRUZ
Active
Individual
MS. SUSAN DE LA CRUZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS CCC-SLP
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
000463
PR
235Z00000X
Speech-Language Pathologist
Primary
109943
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
337937201
—
TX
01
—
8ES497
BLUE CROSS BLUE SHIELD
TX
Enumeration date
04/23/2012
Last updated
03/09/2015
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