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Individual

MR. COBY CRANDALL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
CPSS

Contact information

Practice address
211 ASHE AVE, 27, RALEIGH, NC 27605-1877
(919) 675-2443
Mailing address
211 ASHE AVE, 27, RALEIGH, NC 27605-1877
(919) 675-2443

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
175T00000X
Peer Specialist
2016-3282-01
NC

Other

Enumeration date
09/26/2016
Last updated
06/08/2017
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