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Individual
MR. TERRY DWIGHT CRICKENBERGER
Active
Individual
MR. TERRY DWIGHT CRICKENBERGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP, CNS
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
0015000523
VA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
0017139232
VA
Other
Enumeration date
12/06/2011
Last updated
09/19/2012
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