Individual
MS. SHIRLEEN CROCKER
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
L.D.
Contact information
Practice address
314 E LEE ST, THOMASTON, GA 30286-4122
(706) 647-7148
(706) 647-3372
Mailing address
PO BOX 409, MARSHALLVILLE, GA 31057-0409
(478) 967-2195
(706) 647-3372
Taxonomy
Speciality
Code
Description
License number
State
133NN1002X
Nutrition Education Nutritionist
Primary
LD001487
GA
Other
Enumeration date
09/14/2005
Last updated
07/08/2007
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