Provider Demographics
NPI:1588978340
Name:KRAMEK, MARY FINN (EDS)
Entity type:Individual
Prefix:MRS
First Name:MARY
Middle Name:FINN
Last Name:KRAMEK
Suffix:
Gender:F
Credentials:EDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:810 RIVER TRL
Mailing Address - Street 2:
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32963-3934
Mailing Address - Country:US
Mailing Address - Phone:772-633-1290
Mailing Address - Fax:
Practice Address - Street 1:2170 45TH ST
Practice Address - Street 2:
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32967-1593
Practice Address - Country:US
Practice Address - Phone:772-567-0061
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-03
Last Update Date:2010-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSS302103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool