Mickey Crothers, Ph.d., Llc | |
4330 Golf Ter Suite 213-m Eau Claire WI 54701-4683 | |
(715) 830-1400 | |
Not Available |
Full Name | Mickey Crothers, Ph.d., Llc |
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Speciality | Psychologist |
Location | 4330 Golf Ter, Eau Claire, Wisconsin |
Authorized Official Name and Position | Marie K. (mickey) Crothers (MEMBER) |
Authorized Official Contact | 7158301400 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Mickey Crothers, Ph.d., Llc 4330 Golf Ter Suite 213-m Eau Claire WI 54701-4683 Ph: (715) 830-1400 | Mickey Crothers, Ph.d., Llc 4330 Golf Ter Suite 213-m Eau Claire WI 54701-4683 Ph: (715) 830-1400 |
NPI Number | 1467874990 |
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Provider Enumeration Date | 01/17/2014 |
Last Update Date | 02/18/2014 |
Medicare PECOS PAC ID | 5294967030 |
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Medicare Enrollment ID | O20140410000764 |
Identifier | Type | State | Issuer |
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1467874990 | NPI | - | NPPES |
Provider Name | Marie K Crothers |
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Provider Type | Practitioner - Clinical Psychologist |
Provider Identifiers | NPI Number: 1699728329 PECOS PAC ID: 4183811847 Enrollment ID: I20101207000537 |
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