Individual
TRAVIS WADE CRONIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
90 HOPE DR, MOUNTAIN HOME A F B, ID 83648-1057
(208) 828-7582
Mailing address
90 HOPE DR, MOUNTAIN HOME A F B, ID 83648-1057
(208) 828-7582
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LCSW 31117
ID
Other
Enumeration date
09/27/2011
Last updated
11/06/2011
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