NPI | 1003149790 |
---|---|
Former Name | NICOLE L CROSS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103T00000X Psychologist (Licence: ND 479) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: ND 479) |
103TC0700X Psychologist, Clinical (Licence: MN LP 5446) | |
Enumeration Date | 2009-09-11 |
Last Update Date | 2022-03-31 |