Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 104100000X | Social Worker | 99074721A | IN |
NPI | 1003361510 |
---|---|
Provider Name | Aryn Cross |
First Address | Jasper, IN 47547-0769 |
Second Address | Tell City, IN 47586-1407 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/08/2016 |
Last Update Date | 25/08/2016 |