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Individual
TRACY E CROSS
Active
Individual
TRACY E CROSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
PC009806
PA
101YM0800X
Mental Health Counselor
PC009806
PA
101YP2500X
Professional Counselor
Primary
PC009806
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14084174
CAQH
—
Enumeration date
06/24/2015
Last updated
11/16/2020
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