Provider Demographics
NPI:1568670909
Name:CRUZ, RAINLILLY (MA, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:RAINLILLY
Middle Name:
Last Name:CRUZ
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6545 MILE 21 N
Mailing Address - Street 2:
Mailing Address - City:MONTE ALTO
Mailing Address - State:TX
Mailing Address - Zip Code:78538-3130
Mailing Address - Country:US
Mailing Address - Phone:956-532-6038
Mailing Address - Fax:956-447-1452
Practice Address - Street 1:3501 MORELAND DR
Practice Address - Street 2:
Practice Address - City:WESLACO
Practice Address - State:TX
Practice Address - Zip Code:78596-9132
Practice Address - Country:US
Practice Address - Phone:956-447-9044
Practice Address - Fax:956-447-1452
Is Sole Proprietor?:No
Enumeration Date:2007-05-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX100557235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist