Individual
ERIC TY CRUTCHFIELD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
1502 MARY KAY AVE, BENTON, AR 72015
(501) 315-3344
Mailing address
PO BOX 1589, BENTON, AR 72018-1589
(501) 315-3344
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
2545-C
AR
Other
Enumeration date
05/11/2007
Last updated
01/26/2011
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