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Individual

IMELDA JEAN CROTHERS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
52 RICHLAND DR, BELTON, TX 76513-5769
(254) 654-0055
(800) 747-3074
Mailing address
100 N HOWARD ST STE R, SPOKANE, WA 99201-0508
(254) 654-0055

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
55289
TX
1041C0700X
Clinical Social Worker
Primary
LW61626650
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
55289
TX LCSW LICENSE
TX
Enumeration date
03/21/2017
Last updated
01/14/2025
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