Provider Demographics
NPI:1891236030
Name:CRUZ, ALICE (THL/ATF)
Entity Type:Individual
Prefix:
First Name:ALICE
Middle Name:
Last Name:CRUZ
Suffix:
Gender:F
Credentials:THL/ATF
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 8548
Mailing Address - Street 2:
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00726-8548
Mailing Address - Country:US
Mailing Address - Phone:787-704-7101
Mailing Address - Fax:
Practice Address - Street 1:CARR 172
Practice Address - Street 2:URB TURABO GARDENS
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00726
Practice Address - Country:US
Practice Address - Phone:787-704-7102
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-20
Last Update Date:2017-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR7222355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant