Provider Demographics
NPI:1598903494
Name:CROSS, TERESITA HERNANDEZ (LPC)
Entity Type:Individual
Prefix:MRS
First Name:TERESITA
Middle Name:HERNANDEZ
Last Name:CROSS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6004 ROYALOAK DR
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76016-1034
Mailing Address - Country:US
Mailing Address - Phone:214-354-1106
Mailing Address - Fax:817-496-9956
Practice Address - Street 1:6004 ROYALOAK DR
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76016-1034
Practice Address - Country:US
Practice Address - Phone:214-354-1106
Practice Address - Fax:817-496-9956
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-30
Last Update Date:2009-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX17983101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional