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Individual

ASHLEY MOORE CRUZ

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LPC

Contact information

Practice address
1301 BRIDGEPORT WAY APT 210, SUFFOLK, VA 23435-1971
(760) 751-9616
Mailing address
3575 BRIDGE RD STE 8, PMB #260, SUFFOLK, VA 23435-3361
(805) 630-9734

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
0701013267
VA
101YP2500X
Professional Counselor
Primary
0701013267
VA

Other

Enumeration date
02/01/2024
Last updated
09/02/2024
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