Individual
JESSICA ANNE CRUZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
110 CHURCH ST, PHILADELPHIA, PA 19106-2201
(267) 807-0550
Mailing address
3724 BARING ST UNIT 2R, PHILADELPHIA, PA 19104-7308
(201) 463-5757
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-25-412242
VA
Other
Enumeration date
02/21/2025
Last updated
07/08/2025
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