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General NPI Number Information
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NPI Number | 1902128127
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Entity Type | Individual
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Provider Name | CHARLES DANIEL CROSBY PH.D.
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Gender | Male
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Dates
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Enumeration Date | 02/16/2010
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Last Update Date | 02/16/2010
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Provider Practice Location Address
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Address Line | 2704 GAINES RD SE
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City | HUNTSVILLE
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State | AL
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Zip | 35803-1358
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Country | US
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Telephone | 256-683-5551
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Fax |
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Provider Business Mailing Address
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Address Line | 2704 GAINES RD SE
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City | HUNTSVILLE
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State | AL
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Zip | 35803-1358
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Country | US
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Telephone |
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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 | 1588
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License Number State | AL
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