Doctor Name: | JARED CROY |
NPI Number: | 1023441177 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | CIT |
License Number: | 28536 |
Business Practice Address: | 80 Sharron Ave Plattsburgh, NY - 129014700 |
Business Phone Number: | 5185611447 |
Business Fax Number: | 5185628812 |
Mailing Address: | Po Box 417153, BOSTON |
State: | MA |
Postal Code: | 022417153 |
Phone Number: | 5189528140 |
Fax Number: | 5189528287 |
NPI Enumeration Date: | 08/13/2013 |
NPI Last Update Date: | 08/13/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YA0400X |
License Number: | 28536 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Addiction (Substance Use Disorder) |
Taxonomy Definition: |