Provider Demographics
NPI:1730392903
Name:MARTINEZ CRUZ, MINERVA (PSICOLOGA)
Entity type:Individual
Prefix:DR
First Name:MINERVA
Middle Name:
Last Name:MARTINEZ CRUZ
Suffix:
Gender:F
Credentials:PSICOLOGA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:426 WOBURN ST
Mailing Address - Street 2:
Mailing Address - City:TEWKSBURY
Mailing Address - State:MA
Mailing Address - Zip Code:01876-3437
Mailing Address - Country:US
Mailing Address - Phone:787-238-5167
Mailing Address - Fax:787-778-3113
Practice Address - Street 1:CENTRO PSICOLOGICO Y EDUCATIVO
Practice Address - Street 2:AVE GILBERTO CONCEPCION DE GRACIA #7 3 STE 2
Practice Address - City:SIERRA BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00961
Practice Address - Country:US
Practice Address - Phone:787-778-3113
Practice Address - Fax:787-778-3113
Is Sole Proprietor?:No
Enumeration Date:2007-05-07
Last Update Date:2024-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1677103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist