Provider Demographics
NPI:1124733472
Name:KRAMER, FAITH
Entity type:Individual
Prefix:
First Name:FAITH
Middle Name:
Last Name:KRAMER
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:FAITH
Other - Middle Name:
Other - Last Name:REYNOLDS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 1509
Mailing Address - Street 2:
Mailing Address - City:ROGERS
Mailing Address - State:AR
Mailing Address - Zip Code:72757-1509
Mailing Address - Country:US
Mailing Address - Phone:479-203-7100
Mailing Address - Fax:479-203-7007
Practice Address - Street 1:1400 SW SUSANA ST STE 12
Practice Address - Street 2:
Practice Address - City:BENTONVILLE
Practice Address - State:AR
Practice Address - Zip Code:72713-7877
Practice Address - Country:US
Practice Address - Phone:479-203-7100
Practice Address - Fax:479-203-7007
Is Sole Proprietor?:No
Enumeration Date:2023-01-20
Last Update Date:2025-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YP2500X
P2503017101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional