| NPI | 1124377213 |
|---|---|
| Former Name | HEATHER B CROCKETT |
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IL 149.016280) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| Enumeration Date | 2012-09-05 |
| Last Update Date | 2015-04-27 |