Individual
IYAHNA CROCKETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2460 INDIA HOOK RD STE AND105, ROCK HILL, SC 29732-3530
(803) 366-6250
(803) 366-6261
Mailing address
1321 MURFREESBORO PIKE STE 702, NASHVILLE, TN 37217-2679
(615) 724-4722
(803) 905-4431
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
17-44081
SC
Other
Enumeration date
05/15/2018
Last updated
01/30/2019
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