Healthcare Provider Details

I. General information

NPI: 1568064368
Provider Name (Legal Business Name): DANIEL THOMAS KRANING
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/16/2020
Last Update Date: 11/16/2020
Certification Date: 11/16/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1755 S ST NW
WASHINGTON DC
20009-6107
US

IV. Provider business mailing address

105 WAINWRIGHT DR
ANNAPOLIS MD
21401-2212
US

V. Phone/Fax

Practice location:
  • Phone: 202-234-7738
  • Fax:
Mailing address:
  • Phone: 410-299-3191
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLGPC00763
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: