Provider Demographics
NPI:1407593627
Name:EMILY KERZIN, PH.D. PLLC
Entity Type:Organization
Organization Name:EMILY KERZIN, PH.D. PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:EMILY
Authorized Official - Middle Name:BETH
Authorized Official - Last Name:KERZIN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:707-344-6389
Mailing Address - Street 1:1502 DEVON CIR
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78723-1814
Mailing Address - Country:US
Mailing Address - Phone:707-344-6389
Mailing Address - Fax:
Practice Address - Street 1:1502 DEVON CIR
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78723-1814
Practice Address - Country:US
Practice Address - Phone:707-344-6389
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-18
Last Update Date:2022-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health