Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 102L00000X | Psychologist | ||
Y | 103T00000X | Psychologist |
NPI | 1003433012 |
---|---|
Provider Name | Elizabeth Krumrei |
First Address | Malibu, CA 90263-0001 |
Second Address | Malibu, CA 90265-3201 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/06/2020 |
Last Update Date | 25/06/2020 |