| Doctor Name: | GLENDA ELIB CRUZ |
| NPI Number: | 1003116146 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | |
| Business Practice Address: | 12231 S Eastern Ave Ste 140 Henderson, NV - 890524414 |
| Business Phone Number: | 7023672838 |
| Business Fax Number: | 7029339122 |
| Mailing Address: | 12231 S Eastern Ave, Ste 140 HENDERSON |
| State: | NV |
| Postal Code: | 890524414 |
| Phone Number: | 7023672838 |
| Fax Number: | 7024504239 |
| NPI Enumeration Date: | 10/22/2010 |
| NPI Last Update Date: | 08/05/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TR0400X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Rehabilitation |
| Taxonomy Definition: | |