=====================================================
General NPI Number Information
=====================================================
NPI Number | 1841012796
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | TANIA CRUZ
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/30/2024
-----------------------------------------------------
Last Update Date | 10/30/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 591 WARBURTON AVENUE SUITE 25
-----------------------------------------------------
City | HASTINGS ON HUDSON
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10706
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 914-893-5456
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 591 WARBURTON AVENUE SUITE 25
-----------------------------------------------------
City | HASTINGS ON HUDSON
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10706
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 914-893-5456
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CREATIVE ARTS THERAPIST/OWNER
-----------------------------------------------------
Name | TANIA CRUZ CRUZ
-----------------------------------------------------
Credential | ATR-BC, LCAT
-----------------------------------------------------
Telephone | 914-893-5456
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 221700000X
-----------------------------------------------------
Taxonomy Name | Art Therapist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------