MEDICARE: ERIN KRANTZ RBT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106S00000X	Behavior Technician	RBT-24-343681	MO

General Provider Information

NPI Number	:	1336996669
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ERIN KRANTZ RBT

Provider Business Mailing Address
First Line	:	14405 SALEM RD # NA
Second Line	:
City	:	EXCELSIOR SPRINGS
State	:	MO
Zip	:	64024-8400
Country	:	US
Telephone Number	:	816-585-1272
Fax Number	:

Provider Business Practice Location Address
First Line	:	14405 SALEM RD # NA
Second Line	:
City	:	EXCELSIOR SPRINGS
State	:	MO
Zip	:	64024-8400
Country	:	US
Telephone Number	:	816-585-1272
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/03/2024
Last Update Date	:	05/03/2024

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