Individual
RAVEN CRUZ-HUMBERTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
104 LOCK AND DAM RD, RUSSELLVILLE, AR 72802-9725
(479) 747-5222
Mailing address
104 LOCK AND DAM RD, RUSSELLVILLE, AR 72802-9725
(479) 747-5222
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
04/08/2020
Last updated
10/14/2025
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