Provider Demographics
NPI:1528167004
Name:CRUMLISH, JENNIFER A (PHD)
Entity type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:A
Last Name:CRUMLISH
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 1:1350 CONNECTICUT AVE NW STE 605
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20036-1735
Mailing Address - Country:US
Mailing Address - Phone:240-233-6950
Mailing Address - Fax:202-953-3979
Practice Address - Street 1:1350 CONNECTICUT AVE NW STE 605
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20036-1735
Practice Address - Country:US
Practice Address - Phone:240-233-6950
Practice Address - Fax:202-539-3979
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-21
Last Update Date:2024-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC1915103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical