Provider Demographics
NPI:1881083707
Name:CRUZ, SONIA RAMOS (LPC)
Entity type:Individual
Prefix:MRS
First Name:SONIA
Middle Name:RAMOS
Last Name:CRUZ
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1313 E JOHNSTON AVE
Mailing Address - Street 2:
Mailing Address - City:KINGSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78363-5921
Mailing Address - Country:US
Mailing Address - Phone:361-355-3288
Mailing Address - Fax:
Practice Address - Street 1:1210 NORTH RETAMA DRIVE
Practice Address - Street 2:
Practice Address - City:KINGSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78363-8202
Practice Address - Country:US
Practice Address - Phone:361-593-3991
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-15
Last Update Date:2015-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX67640101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional