Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor |
NPI | 1003435355 |
---|---|
Provider Name | Lauren Paige Cross I |
First Address | Smyrna, TN 37167-8241 |
Second Address | Mt Juliet, TN 37122-4498 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/04/2020 |
Last Update Date | 15/04/2020 |