Individual
MYA KYLENE CRUZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2149 SIEGFRIED AVE, NORTHAMPTON, PA 18067-1241
(845) 527-3256
Mailing address
2149 SIEGFRIED AVE, NORTHAMPTON, PA 18067-1241
(845) 527-3256
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
34913789
PA
Other
Enumeration date
07/28/2026
Last updated
07/28/2026
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