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NPI Code Detail

MEDICARE: ABBIE KRAEMER MA, LAMFT

MEDICARE: ABBIE KRAEMER MA, LAMFT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106H00000XMarriage & Family Therapist2977MN

General Provider Information

NPI Number : 1760832208
Entity Type Code : Individual
Provider Name (Legal Business Name) : ABBIE KRAEMER MA, LAMFT
Provider Business Mailing Address
First Line : 10025 RUSSELL AVE N APT 11
Second Line :
City : BROOKLYN PARK
State : MN
Zip : 55444-1048
Country : US
Telephone Number : 719-237-5338
Fax Number :
Provider Business Practice Location Address
First Line : 4255 PHEASANT RIDGE DR NE STE 412
Second Line :
City : BLAINE
State : MN
Zip : 55449-5066
Country : US
Telephone Number : 719-237-5338
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/15/2016
Last Update Date : 07/06/2022

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