Individual
MS. DIANNA CROCKETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW LSW
Contact information
Practice address
4897 KARL RD, COLUMBUS, OH 43229-5147
(614) 846-2588
Mailing address
3313 RAYNOR DR, COLUMBUS, OH 43219-3256
(614) 260-9491
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
S0600927
OH
103K00000X
Behavior Analyst
Primary
S0600927
OH
Other
Enumeration date
02/29/2016
Last updated
02/29/2016
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