Individual
TIJUANA MCLEOD CROSBY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
9308 CLUB HILL DR, RALEIGH, NC 27617-7572
(919) 806-0088
Mailing address
9308 CLUB HILL DR, RALEIGH, NC 27617-7572
(919) 806-0088
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
2119
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
046WH
BCBS
NC
05
—
6107407
—
NC
Enumeration date
02/01/2007
Last updated
07/08/2007
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