Individual
BENETTA CRUZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CAC II
Contact information
Practice address
509 E 13TH ST, PUEBLO, CO 81001-2940
(719) 546-6666
Mailing address
95 BAYLOR ST, PUEBLO, CO 81005-1637
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
ACB-0007944
CO
Other
Enumeration date
04/12/2018
Last updated
04/12/2018
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