Provider Demographics
NPI:1588234801
Name:CROSS, VALERIE JEAN
Entity Type:Individual
Prefix:
First Name:VALERIE
Middle Name:JEAN
Last Name:CROSS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:VALERIE
Other - Middle Name:JEAN
Other - Last Name:GUNTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:496 OLD ROUTE 66
Mailing Address - Street 2:
Mailing Address - City:SAINT ROBERT
Mailing Address - State:MO
Mailing Address - Zip Code:65584-3728
Mailing Address - Country:US
Mailing Address - Phone:573-246-6161
Mailing Address - Fax:
Practice Address - Street 1:496 OLD ROUTE 66
Practice Address - Street 2:
Practice Address - City:SAINT ROBERT
Practice Address - State:MO
Practice Address - Zip Code:65584-3728
Practice Address - Country:US
Practice Address - Phone:573-246-6161
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-29
Last Update Date:2021-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician