Individual
REGINA CROCKETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
601 N MECHANIC ST, FRANKLIN, VA 23851-1455
(757) 803-4702
(757) 562-1612
Mailing address
601 N MECHANIC ST, FRANKLIN, VA 23851-1455
(757) 803-4702
(757) 562-1612
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
—
Other
Enumeration date
11/29/2018
Last updated
11/29/2018
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