Individual
CARL CROCKHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4325 W ROME BLVD APT 1184, NORTH LAS VEGAS, NV 89084-5409
(702) 561-0866
Mailing address
4325 W ROME BLVD APT 1184, NORTH LAS VEGAS, NV 89084-5409
(702) 561-0866
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
06/24/2014
Last updated
06/24/2014
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