Provider Demographics
NPI:1770397044
Name:CRUZ, MELISSA (RMHCI)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:
Last Name:CRUZ
Suffix:
Gender:F
Credentials:RMHCI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10855 NW 50TH ST APT 103
Mailing Address - Street 2:
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33178-3973
Mailing Address - Country:US
Mailing Address - Phone:786-356-7472
Mailing Address - Fax:
Practice Address - Street 1:10855 NW 50TH ST APT 103
Practice Address - Street 2:
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33178-3973
Practice Address - Country:US
Practice Address - Phone:786-356-7472
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-05
Last Update Date:2025-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL27216101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health