Provider Demographics
NPI:1477941805
Name:DEHLE, CRYSTAL (PHD)
Entity Type:Individual
Prefix:
First Name:CRYSTAL
Middle Name:
Last Name:DEHLE
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 1:1227 UNIVERSITY OF OREGON
Mailing Address - Street 2:DEPARTMENT OF PSYCHOLOGY
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97403-1227
Mailing Address - Country:US
Mailing Address - Phone:541-346-4925
Mailing Address - Fax:
Practice Address - Street 1:1227 UNIVERSITY OF OREGON
Practice Address - Street 2:DEPARTMENT OF PSYCHOLOGY
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97403-1227
Practice Address - Country:US
Practice Address - Phone:541-346-4925
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-08
Last Update Date:2015-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR1840103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical