Individual
TIANTI LYNN CROOK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSS
Contact information
Practice address
2260 WATSON WAY, VISTA, CA 92083-7924
(760) 599-1892
Mailing address
2260 WATSON WAY, VISTA, CA 92083-7924
(760) 599-1892
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
10/06/2020
Last updated
12/19/2022
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