Individual
MR. BRIAN P CROCKETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LADC I
Contact information
Practice address
66 MAIN ST, TAUNTON, MA 02780-2777
(508) 880-1598
Mailing address
66 MAIN ST, TAUNTON, MA 02780-2777
(508) 880-1598
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
2363
MA
Other
Enumeration date
01/24/2011
Last updated
01/24/2011
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