=====================================================
General NPI Number Information
=====================================================
NPI Number | 1598365090
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ERIN CROZIER PHD LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/26/2020
-----------------------------------------------------
Last Update Date | 09/11/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 518 SW 3RD ST STE E
-----------------------------------------------------
City | CORVALLIS
-----------------------------------------------------
State | OR
-----------------------------------------------------
Zip | 97333-4439
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 541-787-3187
-----------------------------------------------------
Fax | 541-787-3187
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 518 SW 3RD ST STE E
-----------------------------------------------------
City | CORVALLIS
-----------------------------------------------------
State | OR
-----------------------------------------------------
Zip | 97333-4439
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 541-787-3187
-----------------------------------------------------
Fax | 541-787-3187
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER, LICENSED PSYCHOLOGIST
-----------------------------------------------------
Name | DR. ERIN F CROZIER
-----------------------------------------------------
Credential | PHD
-----------------------------------------------------
Telephone | 541-787-3187
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 103TC1900X
-----------------------------------------------------
Taxonomy Name | Counseling Psychologist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------