Individual
RHONDA A CROCKETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
401 WESTPARK CT STE 200, PEACHTREE CITY, GA 30269-3572
(800) 341-0120
(866) 341-3403
Mailing address
120 WYONIA WAY, FAYETTEVILLE, GA 30215-2421
(404) 719-9549
(866) 341-3403
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000111222333
CERTIFIED PEER SPECIALIST
GA
Enumeration date
06/09/2019
Last updated
03/12/2020
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