Provider Demographics
NPI:1376506758
Name:CRAIN, VICTORIA (PHD)
Entity Type:Individual
Prefix:DR
First Name:VICTORIA
Middle Name:
Last Name:CRAIN
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 1:315 S ALLEN ST
Mailing Address - Street 2:SUITE 422
Mailing Address - City:STATE COLLEGE
Mailing Address - State:PA
Mailing Address - Zip Code:16801-4849
Mailing Address - Country:US
Mailing Address - Phone:814-234-1053
Mailing Address - Fax:814-237-0890
Practice Address - Street 1:315 S ALLEN ST
Practice Address - Street 2:SUITE 422
Practice Address - City:STATE COLLEGE
Practice Address - State:PA
Practice Address - Zip Code:16801-4849
Practice Address - Country:US
Practice Address - Phone:814-234-1053
Practice Address - Fax:814-237-0890
Is Sole Proprietor?:No
Enumeration Date:2006-04-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS008214L103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling