Individual
DANIEL CROCKETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMSW
Contact information
Practice address
1136 STAFFORD PL, DETROIT, MI 48207-4963
(313) 567-8565
Mailing address
1136 STAFFORD PL, DETROIT, MI 48207-4963
(313) 567-8565
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
6801000446
MI
Other
Enumeration date
06/07/2013
Last updated
06/07/2013
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