Individual
LISA WARREN CROSS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
100 WHITNEY AVE, NEW HAVEN, CT 06510-1283
(203) 865-7445
(203) 222-1596
Mailing address
100 WHITNEY AVE, NEW HAVEN, CT 06510-1283
(203) 865-7445
(203) 222-1596
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
001986
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
600612565
PRACTITIONER ID NUMBER
—
Enumeration date
12/05/2010
Last updated
12/05/2010
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