Carl Crockham
Social Worker, Clinical in North Las Vegas, NV. Individual provider (NPI-1).
NPI number1174938518
StatusActive
Last updated in NPPESJun 24, 2014
Details
- NPI
- 1174938518
- Entity type
- Individual (NPI-1)
- Name
- Carl Crockham
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Jun 24, 2014
- Last updated
- Jun 24, 2014
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1041C0700X | Social Worker, Clinical | – | – | Yes |
Practice location
4325 W Rome Blvd Apt 1184North Las Vegas, NV 89084-5409
Phone 702-561-0866
Mailing address
4325 W Rome Blvd Apt 1184North Las Vegas, NV 89084-5409
Phone 702-561-0866
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