Doctor Name: | MR. CHRISTOPHER HOWARD CROMWELL |
NPI Number: | 1164544631 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | BACHELORS OF ARTS |
License Number: | |
Business Practice Address: | 1900 Lake Tahoe Blvd South Lake Tahoe, CA - 961506305 |
Business Phone Number: | 5305733251 |
Business Fax Number: | |
Mailing Address: | 2031 Nez Perce Dr, SOUTH LAKE TAHOE |
State: | CA |
Postal Code: | 961505358 |
Phone Number: | 5305730315 |
Fax Number: | 5305730315 |
NPI Enumeration Date: | 04/04/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |