Crockett, Theresa
Crockett, Theresa is an individual health care provider with primary practice located at 1543 Kingsley Ave Suite 18A, Orange Park FL 32073-4535. She recently has only one registered license in Behavioral Health & Social Service Providers / Mental Health, which is considered as her primary health care specialty. Crockett, Theresa can be contacted via phone (904) 269-3324.Contact Information
Primary practice address
1543 Kingsley Ave Suite 18A
Orange Park FL 32073-4535
Phone: (904) 269-3324
Fax: (904) 264-2302
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Mental Health | 101YM0800X | MH5726 | Florida |
Profile Details
| NPI number | 1164571683 |
|---|---|
| LBN Legal business name | Crockett, Theresa |
| Credentials | L.M.H.C. |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 10th, 2007 |
| Last updated | May 16th, 2012 - about 12 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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