Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101Y00000X | Counselor | ||
N | 225C00000X | Rehabilitation Counselor |
NPI | 1053472779 |
---|---|
Provider Name | Ms. Cindy Ann Privitt Cross |
First Address | Colusa, CA 95932 |
Second Address | Colusa, CA 95932-2880 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/12/2006 |
Last Update Date | 17/03/2018 |