Individual
DAVID E CROCKETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2730 PACIFIC BLVD SE, ALBANY, OR 97321-5075
(541) 967-3866
Mailing address
PO BOX 100, ALBANY, OR 97321-0031
(541) 967-3866
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
Primary
C9171
OR
Other
Enumeration date
10/03/2017
Last updated
03/31/2025
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