Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103TA0400X | Addiction Psychologist (Substance Use Disorder) | AD003644 | |
Y | 103G00000X | Clinical Psychologist | 2588 | NC |
Y | 103TC0700X | Clinical Psychologist | 2588 | NC |
NPI | 1508978065 |
---|---|
Provider Name | James Christopher Cruise |
First Address | Whittier, NC 28789-6500 |
Second Address | Bryson City, NC 28713-5479 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/08/2006 |
Last Update Date | 09/07/2009 |