Provider Demographics
NPI:1972165199
Name:KRAUSE, DANA ALLYSON (MS,CCC-SLP)
Entity type:Individual
Prefix:
First Name:DANA
Middle Name:ALLYSON
Last Name:KRAUSE
Suffix:
Gender:F
Credentials:MS,CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:219 E 69TH ST APT 4L
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-5454
Mailing Address - Country:US
Mailing Address - Phone:917-294-1095
Mailing Address - Fax:
Practice Address - Street 1:219 E 69TH ST APT 4L
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-5454
Practice Address - Country:US
Practice Address - Phone:917-294-1095
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-08
Last Update Date:2019-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY028146235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist