Provider Demographics
NPI:1922593144
Name:CRUZ, REBECCA (BC-HIS)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:CRUZ
Suffix:
Gender:F
Credentials:BC-HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3675 S RAINBOW BLVD STE 102
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89103-1059
Mailing Address - Country:US
Mailing Address - Phone:702-873-5063
Mailing Address - Fax:702-873-5065
Practice Address - Street 1:3675 S RAINBOW BLVD STE 102
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89103-1059
Practice Address - Country:US
Practice Address - Phone:702-873-5063
Practice Address - Fax:702-873-5065
Is Sole Proprietor?:No
Enumeration Date:2018-06-29
Last Update Date:2018-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVHAS-0559237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist