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NPI Code Detail

MEDICARE: MS. CATHERINE L CROCKETT

MEDICARE:  MS. CATHERINE L CROCKETT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225700000XMassage TherapistLA8344LA

General Provider Information

NPI Number : 1508614900
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. CATHERINE L CROCKETT
Provider Business Mailing Address
First Line : 3310 W OLD SPANISH TRL
Second Line :
City : NEW IBERIA
State : LA
Zip : 70560-9103
Country : US
Telephone Number : 337-492-9787
Fax Number :
Provider Business Practice Location Address
First Line : 925 HARDING ST
Second Line :
City : LAFAYETTE
State : LA
Zip : 70503-2409
Country : US
Telephone Number : 337-492-9787
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/09/2024
Last Update Date : 05/09/2024

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Directions to “ MS. CATHERINE L CROCKETT ” Practice Location

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