Individual
DESIREE CROCKFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
901 DIVISION ST NW, MANDAN, ND 58554-1641
(701) 751-6500
Mailing address
901 DIVISION ST NW, MANDAN, ND 58554-1641
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
1744
ND
Other
Enumeration date
07/08/2020
Last updated
07/08/2020
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