Provider Demographics
NPI:1831840545
Name:CROSS, JENNIFER ELIZABETH
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:ELIZABETH
Last Name:CROSS
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 1:819 REECE RD UNIT 184
Mailing Address - Street 2:
Mailing Address - City:SEVERN
Mailing Address - State:MD
Mailing Address - Zip Code:21144-7509
Mailing Address - Country:US
Mailing Address - Phone:443-891-5171
Mailing Address - Fax:410-847-2893
Practice Address - Street 1:501 W FRANKLIN ST APT 346
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21201-1984
Practice Address - Country:US
Practice Address - Phone:443-891-5171
Practice Address - Fax:410-847-2893
Is Sole Proprietor?:No
Enumeration Date:2022-01-13
Last Update Date:2022-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor