Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YM0800X | Mental Health Counselor | ||
Y | 224Z00000X | Occupational Therapy Assistant | 2125 | TN |
NPI | 1003954918 |
---|---|
Provider Name | Leila Kay Cross |
First Address | Dickson, TN 37055-2259 |
Second Address | Paris, TN 38242-5472 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/02/2007 |
Last Update Date | 12/01/2015 |