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General NPI Number Information
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NPI Number | 1134104367
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Entity Type | Individual
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Provider Name | KATHLEEN A CRIMMINS PH.D.
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Gender | Female
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Dates
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Enumeration Date | 12/09/2005
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Last Update Date | 09/18/2024
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Provider Practice Location Address
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Address Line | 8990 LORRAINE RD
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City | GULFPORT
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State | MS
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Zip | 39503-4176
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Country | US
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Telephone | 228-331-3310
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Fax | 228-284-1608
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Provider Business Mailing Address
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Address Line | 8990 LORRAINE RD
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City | GULFPORT
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State | MS
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Zip | 39503-4176
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Country | US
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Telephone | 228-331-3310
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Fax | 623-856-4433
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 1332
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License Number State | AL
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 641201
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License Number State | MS
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