Individual
MRS. CRYSTALYNN DE LA CRUZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
867 MAIN ST STE 5, MANCHESTER, CT 06040-6034
(860) 325-2541
Mailing address
867 MAIN ST STE 5, MANCHESTER, CT 06040-6034
(860) 966-2399
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
098293052
CT
1041C0700X
Clinical Social Worker
Primary
009966
CT
Other
Enumeration date
06/03/2012
Last updated
04/26/2022
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