Doctor Name: | BRANDON CRUZ |
NPI Number: | 1124358866 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | BA |
License Number: | |
Business Practice Address: | 840 E Plum St Moses Lake, WA - 988371874 |
Business Phone Number: | 5097659239 |
Business Fax Number: | 5097651582 |
Mailing Address: | 840 E Plum St, MOSES LAKE |
State: | WA |
Postal Code: | 988371874 |
Phone Number: | 5097659239 |
Fax Number: | 5097651582 |
NPI Enumeration Date: | 12/31/2009 |
NPI Last Update Date: | 12/31/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |