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Individual

JOHANNA SARAH CROCETTO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
519 MAIN ST, SUITE A, ROYERSFORD, PA 19468-2305
(860) 324-8792
Mailing address
393 COVERED BRIDGE RD, KING OF PRUSSIA, PA 19406-1769
(860) 324-8792

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
SW125699
PA
1041C0700X
Clinical Social Worker
Primary
CW017182
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1487745386
PA
05
461199781
PA
Enumeration date
03/23/2010
Last updated
06/25/2015
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