Individual
TERRY DIANE CROTINGER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
250 PARK AVENUE, RATON, NM 87740
(575) 707-2257
(888) 972-3649
Mailing address
PO BOX 1396, RATON, NM 87740-1396
(575) 707-2257
(888) 972-3649
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
LPC1658
AZ
101YP2500X
Professional Counselor
Primary
LPCC 0159381
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
002479
AHCCCS
AZ
Enumeration date
05/22/2006
Last updated
10/04/2016
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