Provider Demographics
NPI:1265102594
Name:CROOKS, WILLIAM THOMAS
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:THOMAS
Last Name:CROOKS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2180 IMMOKALEE RD STE 101
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34110-1422
Mailing Address - Country:US
Mailing Address - Phone:239-514-2419
Mailing Address - Fax:
Practice Address - Street 1:2180 IMMOKALEE RD STE 101
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34110-1422
Practice Address - Country:US
Practice Address - Phone:239-514-2419
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-17
Last Update Date:2021-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAS5193235500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235500000XSpeech, Language and Hearing Service ProvidersSpecialist/Technologist