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Individual
MRS. SHADORA DELAINE CROCKETT
Active
Individual
MRS. SHADORA DELAINE CROCKETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW, LSW
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
S.2106077
OH
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
09/29/2018
Last updated
10/11/2024
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