Individual
SHANNON LEE CROSS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
4105 TUDOR CENTRE DR, ANCHORAGE, AK 99508-5902
(907) 565-4000
(907) 565-4011
Mailing address
8520 SHRUB CT, ANCHORAGE, AK 99504-2961
(801) 518-6379
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
52466533501
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
52466533501
STATE LICENSE
UT
Enumeration date
01/15/2008
Last updated
01/15/2008
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