Provider Demographics
NPI:1891564829
Name:LAGRONE, CROSBY
Entity Type:Individual
Prefix:
First Name:CROSBY
Middle Name:
Last Name:LAGRONE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1208 TETBURY LN
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78748-4816
Mailing Address - Country:US
Mailing Address - Phone:512-550-0455
Mailing Address - Fax:
Practice Address - Street 1:1208 TETBURY LN
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78748-4816
Practice Address - Country:US
Practice Address - Phone:512-550-0455
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-02
Last Update Date:2024-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician