Provider Demographics
NPI:1043011687
Name:DE LA CRUZ PEREZ, ALANIS TAMARA
Entity type:Individual
Prefix:
First Name:ALANIS
Middle Name:TAMARA
Last Name:DE LA CRUZ PEREZ
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1446 N 6TH ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43201-2508
Mailing Address - Country:US
Mailing Address - Phone:787-515-7898
Mailing Address - Fax:
Practice Address - Street 1:1446 N 6TH ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43201-2508
Practice Address - Country:US
Practice Address - Phone:787-515-7898
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-20
Last Update Date:2025-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool