Individual
MR. MICHAEL ANTHONY CROCCO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.ED, MA, LCMHC
Contact information
Practice address
222 COURT ST, PORTSMOUTH, NH 03801-4416
(603) 674-2438
Mailing address
37 TAMARACK RD, LEE, NH 03861-6317
(603) 674-2438
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
525
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30423232
—
NH
Enumeration date
11/30/2011
Last updated
11/30/2011
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