Doctor Name: | MS. JUDITH A CROTTY |
NPI Number: | 1477657880 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LPC |
License Number: | 000312 |
Business Practice Address: | 29 Chesterfield Rd East Lyme, CT - 06333 |
Business Phone Number: | 8607396974 |
Business Fax Number: | 8607395290 |
Mailing Address: | Po Box 94, EAST LYME |
State: | CT |
Postal Code: | 06333 |
Phone Number: | 8607396974 |
Fax Number: | 8607395290 |
NPI Enumeration Date: | 09/08/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | 000312 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CT |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |