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General NPI Number Information
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NPI Number | 1740497338
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Entity Type | Organization
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Legal Business Name | CROSNO FAMILY PSYCHOLOGY CLINIC LLC
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Dates
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Enumeration Date | 05/16/2007
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Last Update Date | 06/16/2010
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Provider Practice Location Address
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Address Line | 4439 TOWN CENTER PL
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City | KINGWOOD
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State | TX
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Zip | 77339-3714
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Country | US
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Telephone | 281-361-0777
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Fax | 281-361-5777
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Provider Business Mailing Address
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Address Line | 4439 TOWN CENTER PL
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City | KINGWOOD
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State | TX
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Zip | 77339-3714
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Country | US
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Telephone | 281-361-0777
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Fax | 281-361-5777
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | CRYSTAL D RHOADS
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Credential |
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Telephone | 281-361-0777
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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