Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 102L00000X | Psychologist | 479 | ND |
Y | 103T00000X | Psychologist | 479 | ND |
N | 103G00000X | Clinical Psychologist | 479 | ND |
N | 103TC0700X | Clinical Psychologist | 479 | ND |
N | 103G00000X | Clinical Psychologist | LP 5446 | MN |
N | 103TC0700X | Clinical Psychologist | LP 5446 | MN |
NPI | 1003149790 |
---|---|
Provider Name | Nicole L Cross-Hillman |
First Address | Sioux Falls, SD 57117-5074 |
Second Address | Bismarck, ND 58503-1566 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/09/2009 |
Last Update Date | 21/08/2020 |