Individual
SARAH CROCKETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTAL
Contact information
Practice address
8 CARMELITA DRIVE, EAST ALTON, IL 62024
(618) 259-3218
Mailing address
8 CARMELITA DR, EAST ALTON, IL 62024-1817
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
2005013219
MO
Other
Enumeration date
03/20/2007
Last updated
07/08/2007
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