Individual
JENNIFER CROCKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
11650 SW 67TH AVE, TIGARD, OR 97223-8589
(503) 308-9465
Mailing address
11650 SW 67TH AVE, TIGARD, OR 97223-8589
(503) 308-9465
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
C4884
OR
Other
Enumeration date
02/12/2016
Last updated
09/07/2023
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