Most Relevant Information
Provider Data
| NPI Number: | 1003633736 |
| Provider Name: | SHAUNA MARIE CROARKIN ED.S., NCSP |
| Entity Type: | Individual |
| Taxonomy Code: | 103TS0200X |
| Specialty: | Psychologist |
| License Number: | 10101976 |
Most Important Dates
| Enumeration Date: | 09/24/2024 |
| Last Updated: | 09/24/2024 |
Provider Practice Location
1200 BARR ST
FORT WAYNE
IN
468023502
Practice Location Phone/Fax
| Phone: | 2604671124 |
| Fax: | 2604671188 |
Provider Mailing Location
1200 BARR ST
FORT WAYNE
IN
468023502
Provider Mailing Phone/Fax
| Phone: | 2604671124 |
| Fax: | 2604671188 |