Provider Demographics
NPI:1023629789
Name:CRUZ, INEZ ISABEL (PHD, LMSW)
Entity type:Individual
Prefix:
First Name:INEZ
Middle Name:ISABEL
Last Name:CRUZ
Suffix:
Gender:F
Credentials:PHD, LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8915 BRANDING FLD
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78240-5445
Mailing Address - Country:US
Mailing Address - Phone:210-632-4395
Mailing Address - Fax:
Practice Address - Street 1:8915 BRANDING FLD
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78240-5445
Practice Address - Country:US
Practice Address - Phone:210-632-4395
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-14
Last Update Date:2020-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX55755104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker