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Individual
SAMUEL WILLIAM CROUCH
Active
Individual
SAMUEL WILLIAM CROUCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PLADC
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
P-1628
NE
101YM0800X
Mental Health Counselor
Primary
11806
NE
Other
Enumeration date
10/02/2018
Last updated
04/30/2019
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