Provider Demographics
NPI:1457414591
Name:CRUZ, DELMA RENEE (MS, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:DELMA
Middle Name:RENEE
Last Name:CRUZ
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 QUAIL RUN DR
Mailing Address - Street 2:
Mailing Address - City:WARNER ROBINS
Mailing Address - State:GA
Mailing Address - Zip Code:31088-6504
Mailing Address - Country:US
Mailing Address - Phone:478-953-7599
Mailing Address - Fax:
Practice Address - Street 1:2520 RIVERSIDE DR
Practice Address - Street 2:
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31204-1571
Practice Address - Country:US
Practice Address - Phone:478-745-9200
Practice Address - Fax:478-745-9040
Is Sole Proprietor?:No
Enumeration Date:2006-12-19
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GASLP003488235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist