Bradley Dwayne Crockett

NPI #1134867310 in Provo, Utah

Provider Information

NPI Number: 1134867310
Entity Type: Individual
Name: Bradley Dwayne Crockett
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Psychologist - School
Enumeration Date: May 26, 2022
Last Updated: May 26, 2022

Practice Location

Address: 240 WEST 940 NORTH
City: Provo
State: Utah
ZIP Code: 84604
Phone: (801) 374-4800

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Psychologist - School — School	103TS0200X	Primary

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