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General NPI Number Information
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NPI Number | 1962675785
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Entity Type | Organization
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Legal Business Name | REBECCA KRAATZ PLLC
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Dates
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Enumeration Date | 04/13/2008
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Last Update Date | 04/13/2008
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Provider Practice Location Address
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Address Line | 2051 W WHEELER AVE UNIT 5
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City | ARANSAS PASS
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State | TX
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Zip | 78336-4765
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Country | US
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Telephone | 361-643-1263
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Fax |
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Provider Business Mailing Address
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Address Line | 118 SABINE ST
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City | PORTLAND
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State | TX
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Zip | 78374-1454
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Country | US
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Telephone | 361-643-1263
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Fax |
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Authorized Official
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Title or Position | LICENSED PSYCHOLOGIST
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Name | DR. REBECCA ANN KRAATZ
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Credential | PHD
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Telephone | 361-643-6213
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 33490
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License Number State | TX
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