Provider Demographics
NPI:1508630872
Name:RODRIGUEZ-CRUZ, ALICE MIRIAM (TRABAJADOR SOCIAL)
Entity Type:Individual
Prefix:MS
First Name:ALICE
Middle Name:MIRIAM
Last Name:RODRIGUEZ-CRUZ
Suffix:
Gender:F
Credentials:TRABAJADOR SOCIAL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:URB LA CONCEPCION 93 CALLE ALIDA
Mailing Address - Street 2:
Mailing Address - City:CABO ROJO
Mailing Address - State:PR
Mailing Address - Zip Code:00723
Mailing Address - Country:US
Mailing Address - Phone:787-806-5032
Mailing Address - Fax:
Practice Address - Street 1:CALLE ERNESTO RAMOS ANTONINI #155
Practice Address - Street 2:
Practice Address - City:MAYAGUEZ
Practice Address - State:PR
Practice Address - Zip Code:00680
Practice Address - Country:US
Practice Address - Phone:787-805-6325
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-08
Last Update Date:2023-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR169991041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty