Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TR0400X | Rehabilitation Psychologist | 3069 | NC |
NPI | 1689767717 |
---|---|
Provider Name | Kathryn B Crump |
First Address | Charlotte, NC 28203 |
Second Address | Charlotte, NC 28203 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/10/2006 |
Last Update Date | 08/04/2008 |