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General NPI Number Information
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NPI Number | 1952646002
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Entity Type | Organization
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Legal Business Name | LAURA CRIMMINS PLLC
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Dates
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Enumeration Date | 11/30/2012
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Last Update Date | 11/30/2012
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Provider Practice Location Address
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Address Line | 711 WHIPPLE ST
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City | PRESCOTT
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State | AZ
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Zip | 86301-1717
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Country | US
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Telephone | 928-533-2388
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Fax |
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Provider Business Mailing Address
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Address Line | 1571 DONAMIRE CIR
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City | PRESCOTT
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State | AZ
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Zip | 86301-5682
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Country | US
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Telephone | 928-533-2388
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MRS. LAURA ANN CRIMMINS
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Credential | MS, LMFT
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Telephone | 928-533-2388
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | MFT-10275
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | LMFT10275
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License Number State | AZ
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