Most Relevant Information
Provider Data
| NPI Number: | 1003803578 |
| Provider Name: | WANDA A. CROCKETT LPC |
| Entity Type: | Individual |
| Taxonomy Code: | 101YP2500X |
| Specialty: | Counselor |
| License Number: | 07010000950 |
Most Important Dates
| Enumeration Date: | 09/30/2005 |
| Last Updated: | 11/18/2008 |
Provider Practice Location
2006 BREMO RD
SUITE 101
RICHMOND
VA
232262438
Practice Location Phone/Fax
| Phone: | 8042881881 |
| Fax: | 8042881881 |
Provider Mailing Location
2006 BREMO RD
SUITE 101
RICHMOND
VA
232262438
Provider Mailing Phone/Fax
| Phone: | 8042881881 |
| Fax: | 8042881881 |