MEDICARE: DR. NOELLE CHRISTINE DELACRUZ PSY.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TS0200X	School Psychologist	SS1316	FL

General Provider Information

NPI Number	:	1922507045
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NOELLE CHRISTINE DELACRUZ PSY.D.

Provider Business Mailing Address
First Line	:	13505 TUFTS PL
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33626-2948
Country	:	US
Telephone Number	:	845-548-2932
Fax Number	:

Provider Business Practice Location Address
First Line	:	13505 TUFTS PL
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33626-2948
Country	:	US
Telephone Number	:	845-548-2932
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/04/2018
Last Update Date	:	02/04/2018

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