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Organization
WAKE PSYCHOLOGICAL SERVICES, PLLC
Active
Organization
WAKE PSYCHOLOGICAL SERVICES, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TIJUANA CROSBY MA, LPA (PRESIDENT)
(919) 308-8470
Entity
Organization
Contact information
Practice address
9308 CLUB HILL DR, RALEIGH, NC 27617-7572
(919) 308-8470
(919) 806-0088
Mailing address
9308 CLUB HILL DR, RALEIGH, NC 27617-7572
(919) 308-8470
(919) 806-0088
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
2119
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6107407
—
NC
Enumeration date
02/28/2011
Last updated
02/28/2011
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