Provider Demographics
NPI:1194417741
Name:CRUZ, CLAIRE WELLS (OTD)
Entity type:Individual
Prefix:
First Name:CLAIRE
Middle Name:WELLS
Last Name:CRUZ
Suffix:
Gender:
Credentials:OTD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4310 CRYSTAL ERICA LN
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28214-2763
Mailing Address - Country:US
Mailing Address - Phone:678-773-8426
Mailing Address - Fax:
Practice Address - Street 1:2300 GALLBERRY LN
Practice Address - Street 2:
Practice Address - City:WAXHAW
Practice Address - State:NC
Practice Address - Zip Code:28173-0161
Practice Address - Country:US
Practice Address - Phone:704-649-4509
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-23
Last Update Date:2025-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist