Provider Information for 1588201867
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JENNIFER LEA CRUZ LMHC
Sex: Female
NPI: 1588201867
Last Updated: 2023-02-21
Certification Date: 2023-02-21
Certification Date: 2023-02-21
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1588201867 | ||||||||
| Enumeration Date | 2019-12-05 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | NO | ||||||||
| Status | Active | ||||||||
| Mailing Address | 905 WOODMONT LN LAKELAND, FL 33813-1264 United States Phone: 863-812-0899 | Fax: | ||||||||
| Primary Practice Address | 905 WOODMONT LN LAKELAND, FL 33813-1264 United States Phone: 863-812-0899 | Fax: | ||||||||
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