Individual
KOKO KARINA CROCKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1519 NYE RD STE 200, LYONS, NY 14489-9112
(315) 946-5749
Mailing address
1519 NYE RD STE 200, LYONS, NY 14489-9112
(315) 946-5749
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
09/18/2019
Last updated
09/18/2019
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