Provider Demographics
NPI:1083593057
Name:CRUZ-REYES, JENIFER MARISOL
Entity type:Individual
Prefix:MRS
First Name:JENIFER
Middle Name:MARISOL
Last Name:CRUZ-REYES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18461 MATENY RD
Mailing Address - Street 2:
Mailing Address - City:GERMANTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:20874-2100
Mailing Address - Country:US
Mailing Address - Phone:240-715-7011
Mailing Address - Fax:
Practice Address - Street 1:20410 OBSERVATION DR STE 212
Practice Address - Street 2:
Practice Address - City:GERMANTOWN
Practice Address - State:MD
Practice Address - Zip Code:20876-4068
Practice Address - Country:US
Practice Address - Phone:240-296-5862
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-02
Last Update Date:2025-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker