Provider Demographics
NPI:1346569720
Name:CROSSNO, MARYANN (LMFT)
Entity Type:Individual
Prefix:MRS
First Name:MARYANN
Middle Name:
Last Name:CROSSNO
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:718 N BUCKNER BLVD
Mailing Address - Street 2:SUITE 416-112
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75218-2700
Mailing Address - Country:US
Mailing Address - Phone:214-321-1727
Mailing Address - Fax:
Practice Address - Street 1:718 N BUCKNER BLVD
Practice Address - Street 2:SUITE 416-112
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75218-2700
Practice Address - Country:US
Practice Address - Phone:214-321-1727
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-24
Last Update Date:2010-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX200909106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist