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1912025586
CARL CROCKETT
DETROIT, MI
NPI
1912025586
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: MI MA)
Enumeration Date
2007-03-26
Last Update Date
2023-09-25
Business Address
CARL CROCKETT M.A
882 OAKMAN BLVD STE D
DETROIT, MI 48238-4019
Phone number: 313-961-7990
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Mailing Address
CARL CROCKETT M.A
882 OAKMAN BLVD STE D
DETROIT, MI 48238-4019
Phone number: 313-961-7990
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