Individual
DR. MARY CROCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AU.D.
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
A-00696
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A-00696
OHIO BOARD OF SPEECH PATHOLOGY AND AUDIOLOGY
OH
Enumeration date
08/29/2016
Last updated
08/29/2016
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