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General NPI Number Information
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NPI Number | 1730392903
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Entity Type | Individual
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Provider Name | MINERVA MARTINEZ CRUZ PSICOLOGA
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Gender | Female
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Dates
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Enumeration Date | 05/07/2007
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Last Update Date | 06/17/2024
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Provider Practice Location Address
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Address Line | CENTRO PSICOLOGICO Y EDUCATIVO AVE GILBERTO CONCEPCION DE GRACIA #7 3 STE 2
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City | SIERRA BAYAMON
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State | PR
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Zip | 00961
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Country | US
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Telephone | 787-778-3113
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Fax | 787-778-3113
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Provider Business Mailing Address
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Address Line | 426 WOBURN ST
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City | TEWKSBURY
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State | MA
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Zip | 01876-3437
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Country | US
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Telephone | 787-238-5167
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Fax | 787-778-3113
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 1677
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License Number State | PR
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