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1164571683
THERESA CROCKETT
ORANGE PARK, FL
NPI
1164571683
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YM0800X Counselor, Mental Health
(Licence: FL MH5726)
Enumeration Date
2007-01-10
Last Update Date
2012-05-16
Business Address
-- THERESA CROCKETT L.M.H.C.
1543 KINGSLEY AVE SUITE 18A
ORANGE PARK, FL 32073-4535
Phone number: 904-269-3324
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Mailing Address
-- THERESA CROCKETT L.M.H.C.
1543 KINGSLEY AVE SUITE 18A
ORANGE PARK, FL 32073-4535
Phone number: 904-269-3324
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