Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Mr. Immanuel T Cruz, OTR

Individual provider Occupational Therapist · NPI 1780964387

Mr. Immanuel T Cruz, OTR is an Occupational Therapist in Stone Mountain, Georgia. Practices as a sole proprietor. Licensed in Georgia.

Licensed in
GA
In the registry since
2011
What do these letters mean?
OTR — Occupational Therapist, Registered
A nationally registered occupational therapist.

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Practice location Address checks out

2155 W Park Ct Ste G
Stone Mountain, GA 30087-3500
Phone: (770) 465-5084
Fax: (770) 465-5304
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Occupational Therapist (primary) Taxonomy 225X00000X · Licence OT004739 (GA)

Record details

NPI number1780964387
Entity typeIndividual (Type 1)
GenderMale
Credentials OTR
Sole proprietorYes
NPI enumeratedAugust 26, 2011
Last updated in NPPESAugust 26, 2011

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