Most Relevant Information
Provider Data
| NPI Number: | 1003445214 |
| Provider Name: | RAVEN CRUZ-HUMBERTO |
| Entity Type: | Individual |
| Taxonomy Code: | 101Y00000X |
| Specialty: | Counselor |
| License Number: |
Most Important Dates
| Enumeration Date: | 04/08/2020 |
| Last Updated: | 04/08/2020 |
Provider Practice Location
700 E PARKWAY DR
RUSSELLVILLE
AR
728014202
Practice Location Phone/Fax
| Phone: | 8669210149 |
| Fax: | 4797774400 |
Provider Mailing Location
700 E PARKWAY DR
RUSSELLVILLE
AR
728014202
Provider Mailing Phone/Fax
| Phone: | 8669210149 |
| Fax: | 4797774400 |