Individual
KELLY CRUZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4800 E 17160 N, MORONI, UT 84646
(435) 851-9664
(435) 436-5322
Mailing address
PO BOX 28, MORONI, UT 84646-0028
(435) 851-9664
(435) 436-5322
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
08/21/2014
Last updated
08/21/2014
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