Provider Demographics
NPI:1396155784
Name:KRIEGER, ALIZA YUDIT (PHD)
Entity type:Individual
Prefix:DR
First Name:ALIZA
Middle Name:YUDIT
Last Name:KRIEGER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:245 WATERMAN ST
Mailing Address - Street 2:SUITE 202
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02906-5215
Mailing Address - Country:US
Mailing Address - Phone:401-286-6703
Mailing Address - Fax:
Practice Address - Street 1:245 WATERMAN ST
Practice Address - Street 2:SUITE 202
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02906-5215
Practice Address - Country:US
Practice Address - Phone:401-273-3322
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-05-06
Last Update Date:2014-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIPS01344103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical