Healthcare Provider Details

I. General information

NPI: 1801428883
Provider Name (Legal Business Name): JOANNA CRUZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/07/2020
Last Update Date: 02/07/2020
Certification Date: 02/07/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

613 W SESAME DR
HARLINGEN TX
78550-7930
US

IV. Provider business mailing address

613 W SESAME DR
HARLINGEN TX
78550-7930
US

V. Phone/Fax

Practice location:
  • Phone: 956-399-4500
  • Fax:
Mailing address:
  • Phone: 956-399-4500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: