Healthcare Provider Details

I. General information

NPI: 1275301269
Provider Name (Legal Business Name): BRACHA YEHUDIS KRASNER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/19/2023
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

31 WALKER AVE
BALTIMORE MD
21208-4022
US

IV. Provider business mailing address

3717 CLARINTH RD
BALTIMORE MD
21215-2403
US

V. Phone/Fax

Practice location:
  • Phone: 410-415-3515
  • Fax:
Mailing address:
  • Phone: 443-453-3074
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number12021
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: