Individual
CAROLYN J CRUSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSY.D
Contact information
Practice address
5501 BRYAN ST, DALLAS, TX 75206-8103
(214) 828-2603
(214) 828-4954
Mailing address
5501 BRYAN ST, DALLAS, TX 75206-8103
(214) 828-2603
(214) 828-4954
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
33253
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
185673401
—
TX
Enumeration date
11/29/2006
Last updated
09/18/2007
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