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General NPI Number Information
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NPI Number | 1871870675
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Entity Type | Individual
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Provider Name | KIMBALL T KRAUS MS, LMFT
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Gender | Female
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Dates
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Enumeration Date | 11/08/2011
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Last Update Date | 11/08/2011
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Provider Practice Location Address
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Address Line | 3109 W LAKE RD
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City | SKANEATELES
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State | NY
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Zip | 13152-9606
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Country | US
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Telephone | 315-420-4333
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Fax |
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Provider Business Mailing Address
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Address Line | 1551 E. GENESEE ST SUITE 111
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City | SKANEATELES
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State | NY
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Zip | 13152
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Country | US
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Telephone | 315-420-4333
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 06000868
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License Number State | NY
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