Healthcare Provider Details

I. General information

NPI: 1548398225
Provider Name (Legal Business Name): HOPE ANN KRASNER PSYD.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/02/2007
Last Update Date: 01/14/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5800 MCLEOD RD NE STE F
ALBUQUERQUE NM
87109
US

IV. Provider business mailing address

830 LIVE OAK RD NE APT B
ALBUQUERQUE NM
87122-1438
US

V. Phone/Fax

Practice location:
  • Phone: 505-363-0250
  • Fax:
Mailing address:
  • Phone: 505-363-0250
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY1136
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: