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Audrey Crockett
Professional Counselor in Baltimore, Maryland
NPI 1164814489

Audrey Crockett is a Professional Counselor based in Baltimore, MD and is specialized in Professional. Audrey Crockett practices in Baltimore, MD. The NPI Number for Audrey Crockett is 1164814489 and holds a License No. LGP5888 (Maryland).

The current practice location address for Audrey Crockett is 14 S Broadway, Baltimore, MD and can be reached out via phone at 865-228-9412.

Location: 14 S Broadway, Baltimore, MD, 21231-1712
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Provider Profile Details
NPI Number
1164814489
Provider Name
Audrey Crockett
Credential
Provider Entity Type
Individual
Gender
Female
Address
14 S Broadway, Baltimore, MD, 21231-1712
Phone Number
865-228-9412
Fax Number
Provider Enumeration Date
02/24/2015
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
LGP5888 01 MD LGPC
institution
Provider Business Practice Location Address Details
Address
14 S Broadway
City
State
Zip
21231-1712
Phone Number
865-228-9412
Fax Number
person
Provider Business Mailing Address Details
Address
14 S Broadway
City
State
Zip
21231-1712
Phone Number
865-228-9412
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Professional
Taxonomy
License No.
LGP5888 (Maryland)
Definition
Definition to come...
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