Individual
LAUREN KRIVITZKY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
34TH & CIVIC CENTER BLVD, PHILADELPHIA, PA 19104
(215) 590-7555
(215) 590-7387
Mailing address
34TH & CIVIC CENTER BLVD, PHILADELPHIA, PA 19104
(215) 590-7555
(215) 590-7387
Taxonomy
Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
PS017107
PA
103TC2200X
Clinical Child & Adolescent Psychologist
PSY100234
DC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002747200
—
MD
Enumeration date
10/17/2006
Last updated
02/02/2012
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