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Individual

JOHAAN DE LA CRUZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.A.

Contact information

Practice address
55 CALLE DR BASORA N, EDF. MEDICO IV OF. 201, MAYAGUEZ, PR 00680-4810
(787) 265-5583
(787) 265-8145
Mailing address
55 CALLE DR BASORA N, EDF. MEDICO IV OF. 201, MAYAGUEZ, PR 00680-4810
(787) 265-5583
(787) 265-8145

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
3459
PR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
3459
PSICHOLOGIST LICENT
PR
Enumeration date
10/20/2010
Last updated
10/20/2010
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