Individual
SHANNIS DE LA CRUZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1010 WAYNE AVE STE 675, SILVER SPRING, MD 20910
(240) 292-1719
Mailing address
1010 WAYNE AVE STE 675, SILVER SPRING, MD 20910-5676
(240) 292-1719
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
106S00000X
Behavior Technician
—
—
Other
Enumeration date
07/06/2018
Last updated
06/14/2024
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