Individual
MARY NANCY DE LA CRUZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6080 JERICHO TPKE STE 200, COMMACK, NY 11725-2808
(631) 864-7770
Mailing address
59 S CENTRE AVE APT 3D, ROCKVILLE CENTRE, NY 11570-5756
(516) 840-1589
Taxonomy
Speciality
Code
Description
License number
State
106E00000X
Assistant Behavior Analyst
—
—
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
08/24/2023
Last updated
08/24/2023
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