Healthcare Provider Details

I. General information

NPI: 1013573286
Provider Name (Legal Business Name): ERIN FULLER CROZIER PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/14/2019
Last Update Date: 09/11/2023
Certification Date: 09/11/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

518 SW 3RD ST STE E
CORVALLIS OR
97333-4439
US

IV. Provider business mailing address

518 SW 3RD ST STE E
CORVALLIS OR
97333-4439
US

V. Phone/Fax

Practice location:
  • Phone: 541-787-3187
  • Fax: 541-787-3187
Mailing address:
  • Phone: 541-787-3187
  • Fax: 541-787-3187

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number3035
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: