Provider Demographics
NPI:1477920767
Name:CROSBY LEARNING SOLUTIONS
Entity Type:Organization
Organization Name:CROSBY LEARNING SOLUTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:MEGAN
Authorized Official - Middle Name:GRAVOIS
Authorized Official - Last Name:CROSBY
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:832-245-5467
Mailing Address - Street 1:16219 COLE BRIDGE LN
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77429-3979
Mailing Address - Country:US
Mailing Address - Phone:832-245-5467
Mailing Address - Fax:
Practice Address - Street 1:16219 COLE BRIDGE LN
Practice Address - Street 2:
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77429-3979
Practice Address - Country:US
Practice Address - Phone:832-245-5467
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-21
Last Update Date:2015-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1-11-9210103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX460881049OtherINDIVIDUAL TAX ID