Doctor Name: | JUDITH CROP |
NPI Number: | 1912223173 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | L.P.C. |
License Number: | C1921/ACTIVE |
Business Practice Address: | 24004 Se Crane Rd Eagle Creek, OR - 970229786 |
Business Phone Number: | 5036373407 |
Business Fax Number: | |
Mailing Address: | Po Box 598, EAGLE CREEK |
State: | OR |
Postal Code: | 970220598 |
Phone Number: | 5036373407 |
Fax Number: | |
NPI Enumeration Date: | 04/13/2010 |
NPI Last Update Date: | 04/13/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | C1921/ACTIVE |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OR |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |