| Carole J Crane Phd Pa | |
|
1680 Smith St Suite 1 Orange Park FL 32073-4852 | |
| (904) 264-7099 | |
| Not Available |
| Full Name | Carole J Crane Phd Pa |
|---|---|
| Speciality | Clinic/Center |
| Location | 1680 Smith St, Orange Park, Florida |
| Authorized Official Name and Position | Carole J Crane (PRESIDENT) |
| Authorized Official Contact | 9042647099 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Carole J Crane Phd Pa 1680 Smith St Suite 1 Orange Park FL 32073-4852 Ph: (904) 264-7099 | Carole J Crane Phd Pa 1680 Smith St Suite 1 Orange Park FL 32073-4852 Ph: (904) 264-7099 |
| NPI Number | 1689991135 |
|---|---|
| Provider Enumeration Date | 04/23/2010 |
| Last Update Date | 10/29/2013 |
| Medicare PECOS PAC ID | 0749310803 |
|---|---|
| Medicare Enrollment ID | O20100616000358 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689991135 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | PY00002130 (Florida) | Primary |
| Provider Name | Carole J Crane |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1437251501 PECOS PAC ID: 5991786865 Enrollment ID: I20131029001789 |
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