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Individual

MR. TERRY DWIGHT CRICKENBERGER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
NP, CNS

Contact information

Practice address
1355 RICHMOND AVE, STAUNTON, VA 24401-9146
(540) 332-2142
(540) 332-2209
Mailing address
1355 RICHMOND AVE, STAUNTON, VA 24401-9146
(540) 332-2142
(540) 332-2209

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
0015000523
VA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
0017139232
VA

Other

Enumeration date
12/06/2011
Last updated
09/19/2012
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