Individual
EZEQUIEL CRUZ GUTIERREZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MS, MA, LP
Contact information
Practice address
130 W LIBERTY DR STE 200, WHEATON, IL 60187-5138
(630) 277-9579
Mailing address
1335 COLLEGE AVE, WHEATON, IL 60187-5867
(787) 226-5412
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
7146
PR
Other
Enumeration date
08/15/2024
Last updated
08/15/2024
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