Individual
MRS. FARRAH LANETT CROCKETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
114 CRYSTAL CREEK CT, WENTZVILLE, MO 63385-3759
(314) 265-1362
Mailing address
114 CRYSTAL CREEK CT, WENTZVILLE, MO 63385-3759
(314) 265-1362
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Enumeration date
09/13/2018
Last updated
09/13/2018
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