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General NPI Number Information
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NPI Number | 1114425592
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Entity Type | Organization
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Legal Business Name | CROSS THERAPY CENTER PLLC
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Dates
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Enumeration Date | 01/31/2018
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Last Update Date | 01/31/2018
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Provider Practice Location Address
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Address Line | 20 FRANK ST
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City | COUNCIL BLUFFS
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State | IA
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Zip | 51503-4460
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Country | US
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Telephone | 712-256-9000
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Fax | 712-256-7710
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Provider Business Mailing Address
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Address Line | 20 FRANK ST
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City | COUNCIL BLUFFS
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State | IA
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Zip | 51503-4460
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Country | US
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Telephone | 712-256-9000
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Fax | 712-256-7710
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Authorized Official
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Title or Position | OWNER
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Name | KATE CROSS
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Credential | LIMHC
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Telephone | 402-650-0900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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