Healthcare Provider Details

I. General information

NPI: 1912967829
Provider Name (Legal Business Name): RAYMONE BARBARA KRAL PHD LMFT LP LICSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/24/2006
Last Update Date: 02/02/2021
Certification Date: 02/02/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

324 W SUPERIOR ST STE 625
DULUTH MN
55802-1723
US

IV. Provider business mailing address

324 W SUPERIOR ST STE 625
DULUTH MN
55802-1723
US

V. Phone/Fax

Practice location:
  • Phone: 218-606-1797
  • Fax:
Mailing address:
  • Phone: 218-606-1797
  • Fax: 651-925-0039

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number8526
License Number StateMN
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number64
License Number StateMN
# 3
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberLP2873
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: