Doctor Name: | MR. DONALD ALDEN CRONK |
NPI Number: | 1013054345 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.S., LMHC |
License Number: | 39000750A |
Business Practice Address: | 616 E Colfax Ave South Bend, IN - 466172827 |
Business Phone Number: | 5742777734 |
Business Fax Number: | 5742777734 |
Mailing Address: | 616 E Colfax Ave, SOUTH BEND |
State: | IN |
Postal Code: | 466172827 |
Phone Number: | 5742777734 |
Fax Number: | 5742777734 |
NPI Enumeration Date: | 01/30/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | 39000750A |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IN |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |