Provider Demographics
NPI:1699102483
Name:KRAMER, KARA (SLP)
Entity type:Individual
Prefix:
First Name:KARA
Middle Name:
Last Name:KRAMER
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3408 N RIVER RAPIDS DR
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85712-6662
Mailing Address - Country:US
Mailing Address - Phone:217-549-5946
Mailing Address - Fax:
Practice Address - Street 1:3408 N RIVER RAPIDS DR
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85712-6662
Practice Address - Country:US
Practice Address - Phone:217-549-5946
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-10-11
Last Update Date:2024-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2013035190235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO2013035190OtherBOARD OF HEALING ARTS