Healthcare Provider Details

I. General information

NPI: 1013169804
Provider Name (Legal Business Name): ANDREA MARIE KRAMER M.A.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/13/2008
Last Update Date: 08/26/2021
Certification Date: 08/26/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3 BUTTERFIELD TRAIL BLVD
EL PASO TX
79906-4951
US

IV. Provider business mailing address

316 MID VALLEY CTR # 186
CARMEL CA
93923-8516
US

V. Phone/Fax

Practice location:
  • Phone: 800-991-6071
  • Fax: 800-991-6071
Mailing address:
  • Phone:
  • Fax: 800-991-6071

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number845
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: