Provider Demographics
NPI:1154154318
Name:DE LA CRUZ, ANITA MARIA
Entity type:Individual
Prefix:MRS
First Name:ANITA
Middle Name:MARIA
Last Name:DE LA CRUZ
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:ANITA
Other - Middle Name:MARIA
Other - Last Name:DE LA CRUZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:2401 N CENTER RD
Mailing Address - Street 2:
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48603-3734
Mailing Address - Country:US
Mailing Address - Phone:989-482-2383
Mailing Address - Fax:
Practice Address - Street 1:2401 N CENTER RD
Practice Address - Street 2:
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48603-3734
Practice Address - Country:US
Practice Address - Phone:989-482-2383
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-22
Last Update Date:2024-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker