| Doctor Name: | MR. PAUL W CRONSTROM |
| NPI Number: | 1003906066 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.A. |
| License Number: | 6301003291 |
| Business Practice Address: | 789 N Clare Ave Harrison, MI - 486259194 |
| Business Phone Number: | 9895392141 |
| Business Fax Number: | 9895392153 |
| Mailing Address: | Po Box 281, HARRISON |
| State: | MI |
| Postal Code: | 486250281 |
| Phone Number: | 9895390158 |
| Fax Number: | |
| NPI Enumeration Date: | 10/13/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | 6301003291 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MI |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |