Individual
SUZANNE CROCKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2800 MAIN AVE, FARGO, ND 58103-6811
(701) 740-1374
Mailing address
2800 MAIN AVE, FARGO, ND 58103-6811
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
ND
Other
Enumeration date
07/01/2020
Last updated
07/01/2020
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