Individual
MR. DOUGLAS EDWARD CRADDOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMHC, LPCC
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
MH10055
FL
101YP2500X
Professional Counselor
Primary
E-2588
OH
Other
Enumeration date
02/23/2009
Last updated
07/13/2011
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