Provider Demographics
NPI:1134427099
Name:CROSS, NATALIE JOAN (PHD)
Entity type:Individual
Prefix:DR
First Name:NATALIE
Middle Name:JOAN
Last Name:CROSS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:MS
Other - First Name:NATALIE
Other - Middle Name:JOAN
Other - Last Name:SMALL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BA
Mailing Address - Street 1:800 MOYE BOULEVARD
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27858
Mailing Address - Country:US
Mailing Address - Phone:252-830-2149
Mailing Address - Fax:252-830-1191
Practice Address - Street 1:800 MOYE BLVD
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27834-3777
Practice Address - Country:US
Practice Address - Phone:252-830-2149
Practice Address - Fax:252-830-1191
Is Sole Proprietor?:No
Enumeration Date:2011-03-02
Last Update Date:2011-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4090103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical