Provider Demographics
NPI:1245997550
Name:RIOS CRUZ, WILMARIE
Entity type:Individual
Prefix:
First Name:WILMARIE
Middle Name:
Last Name:RIOS CRUZ
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:628 JOHNSON RD
Mailing Address - Street 2:
Mailing Address - City:SICKLERVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08081-9554
Mailing Address - Country:US
Mailing Address - Phone:609-315-5891
Mailing Address - Fax:
Practice Address - Street 1:628 JOHNSON RD
Practice Address - Street 2:
Practice Address - City:SICKLERVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08081-9554
Practice Address - Country:US
Practice Address - Phone:609-315-5891
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-22
Last Update Date:2025-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC01038200101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional