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General NPI Number Information
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NPI Number | 1033250006
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Entity Type | Individual
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Provider Name | THOMAS JOSEPH CROTTY PH.D.
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Gender | Male
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Dates
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Enumeration Date | 02/10/2007
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Last Update Date | 07/09/2007
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Provider Practice Location Address
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Address Line | 290 E COURT ST
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City | PRESTONSBURG
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State | KY
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Zip | 41653-7932
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Country | US
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Telephone | 606-205-0712
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 727
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City | PAINTSVILLE
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State | KY
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Zip | 41240-0727
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Country | US
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Telephone | 606-789-7451
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number | KY1074
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License Number State | KY
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