Individual
EDNA ORIAKHI-CROCKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
35 EARL ST, WATERBURY, CT 06710-1735
(203) 759-1296
Mailing address
35 EARL ST, WATERBURY, CT 06710-1735
(203) 759-1296
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
297991
CT
Other
Enumeration date
10/08/2009
Last updated
10/08/2009
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