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Individual
JAMES JEFFREY CRISCO
Active
Individual
JAMES JEFFREY CRISCO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Taxonomy
Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
613-057
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
39010900
—
WI
Enumeration date
07/23/2008
Last updated
04/22/2009
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