Provider Demographics
NPI:1669232856
Name:DELACRUZ, KENDRA NICOLE (CPCC)
Entity type:Individual
Prefix:
First Name:KENDRA
Middle Name:NICOLE
Last Name:DELACRUZ
Suffix:
Gender:F
Credentials:CPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1011 RALEIGH CIR
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73071-2526
Mailing Address - Country:US
Mailing Address - Phone:405-434-8534
Mailing Address - Fax:
Practice Address - Street 1:1011 RALEIGH CIR
Practice Address - Street 2:
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73071-2526
Practice Address - Country:US
Practice Address - Phone:405-434-8534
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-22
Last Update Date:2024-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist