Provider Demographics
NPI:1225495658
Name:CROSS, CYNTHIA (MT-BC)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:
Last Name:CROSS
Suffix:
Gender:F
Credentials:MT-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13109 S 28TH ST
Mailing Address - Street 2:
Mailing Address - City:VICKSBURG
Mailing Address - State:MI
Mailing Address - Zip Code:49097-8391
Mailing Address - Country:US
Mailing Address - Phone:269-254-6942
Mailing Address - Fax:
Practice Address - Street 1:111 W PRAIRIE ST
Practice Address - Street 2:
Practice Address - City:VICKSBURG
Practice Address - State:MI
Practice Address - Zip Code:49097-1258
Practice Address - Country:US
Practice Address - Phone:260-254-6942
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-01-15
Last Update Date:2016-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist