Provider Demographics
NPI:1669971966
Name:CRUZ RAMOS, CARMEN DENNISE
Entity type:Individual
Prefix:
First Name:CARMEN
Middle Name:DENNISE
Last Name:CRUZ RAMOS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:243 9TH ST
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:MD
Mailing Address - Zip Code:21122-4965
Mailing Address - Country:US
Mailing Address - Phone:410-437-8349
Mailing Address - Fax:
Practice Address - Street 1:243 9TH ST
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:MD
Practice Address - Zip Code:21122-4965
Practice Address - Country:US
Practice Address - Phone:410-437-8349
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-02
Last Update Date:2018-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician