Provider Information for 1891273462
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Ms. SHANDREKA CROFT LMFT
Other Names:Other Name:Ms. SHAN CROFT LMFTSex: Female
NPI: 1891273462
Last Updated: 2018-08-05
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||
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| NPI | 1891273462 | ||||||||
| Enumeration Date | 2018-08-05 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | NO | ||||||||
| Status | Active | ||||||||
| Mailing Address | 616 OAK CIR MOULTRIE, GA 31768-2932 United States Phone: 229-699-4868 | Fax: | ||||||||
| Primary Practice Address | 20 11TH AVE SE MOULTRIE, GA 31768-5650 United States Phone: 229-616-1044 | Fax: | ||||||||
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