Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | SW000503 | MO |
NPI | 1003095290 |
---|---|
Provider Name | Mrs. Rosemary F. Crofford |
First Address | Florissant, MO 63031-3727 |
Second Address | Florissant, MO 63031-3727 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/10/2007 |
Last Update Date | 24/10/2007 |