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Organization
WANDA A. CROCKETT PLLC
Active
Organization
WANDA A. CROCKETT PLLC
Active
Other names
New Direction Psychiatric
Organization subpart
No
Provider details
NPI number
Authorized official
MS. WANDA A. CROCKETT L.P.C. (OWNER)
(804) 748-4774
Entity
Organization
Contact information
Practice address
1480 OAK BRIDGE CT, POWHATAN, VA 23139-8054
(804) 423-1389
Mailing address
9500 GADWELL TER, CHESTERFIELD, VA 23838-5215
(804) 748-4774
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
Other
Enumeration date
04/04/2007
Last updated
11/18/2008
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