MEDICARE: DR. JENNIFER A CRUMLISH PH.D.

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
1	103TC0700X	Clinical Psychologist	1915	DC

General Provider Information

NPI Number	:	1528167004
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JENNIFER A CRUMLISH PH.D.

Provider Business Mailing Address
First Line	:	1350 CONNECTICUT AVE NW STE 605
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20036-1735
Country	:	US
Telephone Number	:	240-233-6950
Fax Number	:	202-953-3979

Provider Business Practice Location Address
First Line	:	1350 CONNECTICUT AVE NW STE 605
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20036-1735
Country	:	US
Telephone Number	:	240-233-6950
Fax Number	:	202-539-3979

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/21/2006
Last Update Date	:	01/31/2024

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