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Individual

SANDRA GAIL CROCKER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LPC, CSAC, CRC

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
0701007231
VA
101YA0400X
Addiction (Substance Use Disorder) Counselor
0710102955
VA
225C00000X
Rehabilitation Counselor
00116571
VA

Other

Enumeration date
12/05/2017
Last updated
12/05/2017
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