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Individual

MR. DAVID L CRANE

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
LPCC

Contact information

Practice address
102 E HIGH ST, TUCUMCARI, NM 88401-2726
(505) 461-6200
(505) 461-0404
Mailing address
102 E HIGH ST, P.O. BOX 881, TUCUMCARI, NM 88401-2726
(505) 461-6200
(505) 461-0404

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
006177
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
43220380
NM
01
NM100178
INDIV PROV MEDICAID
NM
Enumeration date
02/17/2006
Last updated
07/08/2007
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