| Doctor Name: | MR. LOUIS RAY CRADDOCK |
| NPI Number: | 1629177423 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MS |
| License Number: | 670 |
| Business Practice Address: | 800 Seneca Dr Belpre, OH - 457141141 |
| Business Phone Number: | 7404234707 |
| Business Fax Number: | 7404236976 |
| Mailing Address: | 800 Seneca Dr, BELPRE |
| State: | OH |
| Postal Code: | 457141141 |
| Phone Number: | 7404234707 |
| Fax Number: | 7404236976 |
| NPI Enumeration Date: | 09/21/2006 |
| NPI Last Update Date: | 07/09/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TA0400X |
| License Number: | 670 |
| Healthcare Provider Taxonomy: (Secondary) | X |
| State: | WV |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |