Provider Demographics
NPI:1669104352
Name:CRUZ, LAURANGELICA (PSYD)
Entity type:Individual
Prefix:MRS
First Name:LAURANGELICA
Middle Name:
Last Name:CRUZ
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HC 7 BOX 31966
Mailing Address - Street 2:
Mailing Address - City:HATILLO
Mailing Address - State:PR
Mailing Address - Zip Code:00659-9313
Mailing Address - Country:US
Mailing Address - Phone:787-242-4202
Mailing Address - Fax:
Practice Address - Street 1:CARR 134 KM 13.1 INT CALLE A #35
Practice Address - Street 2:BO. BAYANEY PARC ANGEL VELEZ
Practice Address - City:HATILLO
Practice Address - State:PR
Practice Address - Zip Code:00659
Practice Address - Country:US
Practice Address - Phone:787-242-4202
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-30
Last Update Date:2022-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR7336103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty