Crockett, Wanda A.

Crockett, Wanda A. is an individual health care provider with primary practice located at 2006 Bremo Rd Suite 101, Richmond VA 23226-2438. She recently has only one registered license in Behavioral Health & Social Service Providers / Professional, which is considered as her primary health care specialty. Crockett, Wanda A. can be contacted via phone (804) 288-1881.

Contact Information

Primary practice address
2006 Bremo Rd Suite 101 Richmond VA 23226-2438
Phone: (804) 288-1881
Fax: (804) 288-1881
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Professional 101YP2500X 07010000950 Virginia

Profile Details

NPI number 1003803578
LBN Legal business name Crockett, Wanda A.
Credentials Licensed Professional Counselor (LPC)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 30th, 2005
Last updated Nov 18th, 2008 - about 17 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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Identifiers

StateTypeNumberIssuer
All States NPI 1003803578 NPPES
Virginia MEDICAID 005401895

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