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General NPI Number Information
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NPI Number | 1518347632
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Entity Type | Individual
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Provider Name | CRYSTAL KRUEGER LMFT
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Gender | Female
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Dates
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Enumeration Date | 06/03/2015
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Last Update Date | 04/11/2024
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Provider Practice Location Address
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Address Line | 14535 W INDIAN SCHOOL RD STE 120
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City | GOODYEAR
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State | AZ
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Zip | 85395-9282
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Country | US
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Telephone | 623-335-2290
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Fax |
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Provider Business Mailing Address
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Address Line | 24654 N LAKE PLEASANT PKWY # 103-176
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City | PEORIA
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State | AZ
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Zip | 85383-1359
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Country | US
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Telephone | 623-335-2290
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Fax |
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | LMFT-15256
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License Number State | AZ
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