| Doctor Name: | MARY KRISTINE SUNGAHID DELA CRUZ |
| NPI Number: | 1235475203 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PT |
| License Number: | 2305206561 |
| Business Practice Address: | 201 Eppes St Hopewell, VA - 238602717 |
| Business Phone Number: | 1804541144 |
| Business Fax Number: | |
| Mailing Address: | 100 Lakeview Park Rd, Apt 100 COLONIAL HEIGHTS |
| State: | VA |
| Postal Code: | 238341614 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 12/19/2012 |
| NPI Last Update Date: | 12/19/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2251G0304X |
| License Number: | 2305206561 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | VA |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | Geriatrics |
| Taxonomy Definition: | |