| Doctor Name: | TRAVIS WADE CRONIN |
| NPI Number: | 1811270697 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | LCSW |
| License Number: | LCSW 31117 |
| Business Practice Address: | 90 Hope Dr Mountain Home A F B, ID - 836481057 |
| Business Phone Number: | 2088287582 |
| Business Fax Number: | |
| Mailing Address: | 90 Hope Dr, MOUNTAIN HOME A F B |
| State: | ID |
| Postal Code: | 836481057 |
| Phone Number: | 2088287582 |
| Fax Number: | |
| NPI Enumeration Date: | 09/27/2011 |
| NPI Last Update Date: | 11/06/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | LCSW 31117 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | ID |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |