Organization
MICKEY CROTHERS, PH.D., LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARIE K. (MICKEY) CROTHERS PH.D. (MEMBER)
(715) 830-1400
Entity
Organization
Contact information
Practice address
4330 GOLF TER, SUITE 213-M, EAU CLAIRE, WI 54701-4683
(715) 830-1400
Mailing address
4330 GOLF TER, SUITE 213-M, EAU CLAIRE, WI 54701-4683
(715) 830-1400
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
103T00000X
Psychologist
Primary
—
—
103TC0700X
Clinical Psychologist
—
—
Other
Enumeration date
01/17/2014
Last updated
02/18/2014
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