Healthcare Provider Details

I. General information

NPI: 1346157872
Provider Name (Legal Business Name): HAILEE MARIE CRUZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/27/2026
Last Update Date: 08/27/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

102 PERIMETER RD
NASHUA NH
03063-1301
US

IV. Provider business mailing address

200 GRIFFIN RD STE 5
PORTSMOUTH NH
03801-7145
US

V. Phone/Fax

Practice location:
  • Phone: 603-600-3201
  • Fax:
Mailing address:
  • Phone: 603-600-3223
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: