Provider Demographics
NPI:1952625493
Name:CRUZ, VICTORIA ROSE (BS)
Entity type:Individual
Prefix:MRS
First Name:VICTORIA
Middle Name:ROSE
Last Name:CRUZ
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8203 W ORAIBI DR
Mailing Address - Street 2:#2013
Mailing Address - City:PEORIA
Mailing Address - State:AZ
Mailing Address - Zip Code:85382-4680
Mailing Address - Country:US
Mailing Address - Phone:623-205-7700
Mailing Address - Fax:
Practice Address - Street 1:6805 N 125TH AVE
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85307-2402
Practice Address - Country:US
Practice Address - Phone:623-742-3956
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-03-25
Last Update Date:2010-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZSLPA63522355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant