Doctor Name: | EMILY BROOKE CRONKHITE |
NPI Number: | 1649625625 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MFTI |
License Number: | 2328 |
Business Practice Address: | 24028 Lake Dr Suite A Crestline, CA - 92325 |
Business Phone Number: | 9093383222 |
Business Fax Number: | |
Mailing Address: | Po Box 4644, BLUE JAY |
State: | CA |
Postal Code: | 923174644 |
Phone Number: | 9093383222 |
Fax Number: | |
NPI Enumeration Date: | 04/27/2016 |
NPI Last Update Date: | 04/27/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 2328 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | CA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |