Individual
MRS. JENNAFER JOLLEEN CROCKETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMHC, MFT
Contact information
Practice address
1010 S GARDEN AVE, ROSWELL, NM 88203-6866
(575) 623-7660
(575) 623-2604
Mailing address
202 E EARLL DR STE 200, PHOENIX, AZ 85012-2647
(575) 623-1480
(575) 622-3325
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
0172701
NM
104100000X
Social Worker
—
—
Other
Enumeration date
03/12/2014
Last updated
03/05/2015
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