MEDICARE: ANNA MARIE CROSS L.P.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	19175	TX

General Provider Information

NPI Number	:	1629182944
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANNA MARIE CROSS L.P.C.

Provider Business Mailing Address
First Line	:	5011 PINE PRARIE LN
Second Line	:
City	:	KINGWOOD
State	:	TX
Zip	:	77345-2007
Country	:	US
Telephone Number	:	281-361-4708
Fax Number	:

Provider Business Practice Location Address
First Line	:	2323 TIMBER SHADOWS DR
Second Line	:	SUITE B
City	:	KINGWOOD
State	:	TX
Zip	:	77339-2028
Country	:	US
Telephone Number	:	281-657-6052
Fax Number	:	281-657-6052

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/17/2006
Last Update Date	:	07/08/2007

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