Organization
CREDLE ROCKERS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CRYSTAL LOCKWOOD (DIRECTOR)
(919) 404-9290
Entity
Organization
Contact information
Practice address
2925 BATTLECREST DR, DECATUR, GA 30034-2600
(919) 404-9290
Mailing address
2925 BATTLECREST DR, DECATUR, GA 30034-2600
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
—
—
225100000X
Physical Therapist
—
—
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Enumeration date
11/20/2019
Last updated
11/20/2019
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