Individual
MICHAEL MARVIN THOMAS CRADDOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.ED
Contact information
Practice address
5 N LESLIE ST, ANACONDA, MT 59711-9304
(406) 565-3094
Mailing address
5 N LESLIE ST, ANACONDA, MT 59711-9304
(406) 565-3094
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
BBH-LCPC-LIC-19613
MT
Other
Enumeration date
11/20/2016
Last updated
11/29/2016
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