MEDICARE: CRYSTAL LEIGH DELACRUZ

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	106S00000X	Behavior Technician		NC

General Provider Information

NPI Number	:	1649141623
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CRYSTAL LEIGH DELACRUZ

Provider Business Mailing Address
First Line	:	240 RACINE DR STE 100
Second Line	:
City	:	WILMINGTON
State	:	NC
Zip	:	28403-8703
Country	:	US
Telephone Number	:	910-202-4103
Fax Number	:

Provider Business Practice Location Address
First Line	:	226 BRIDGETON CT
Second Line	:
City	:	WILMINGTON
State	:	NC
Zip	:	28411-8602
Country	:	US
Telephone Number	:	919-108-5905
Fax Number	:

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

Provider Enumeration Date	:	09/15/2025
Last Update Date	:	01/19/2026

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Directions to “ CRYSTAL LEIGH DELACRUZ ” Practice Location

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