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General NPI Number Information
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NPI Number | 1205292547
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Entity Type | Individual
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Provider Name | ALLISON CROSS
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Gender | Female
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Dates
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Enumeration Date | 12/31/2015
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Last Update Date | 11/18/2019
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Provider Practice Location Address
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Address Line | 1619 DAYTON AVE STE 111
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City | SAINT PAUL
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State | MN
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Zip | 55104-6276
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Country | US
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Telephone | 612-305-8471
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Fax | 612-234-4628
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Provider Business Mailing Address
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Address Line | 1123 GRAND AVE APT 103
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City | SAINT PAUL
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State | MN
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Zip | 55105-2744
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Country | US
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Telephone | 612-305-8471
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 3439
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License Number State | MN
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