MEDICARE: MISS MADISON MARIA KRAEMER MS, CF-SLP

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	235Z00000X	Speech-Language Pathologist	2022032764	MO

General Provider Information

NPI Number	:	1457079790
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS MADISON MARIA KRAEMER MS, CF-SLP

Provider Business Mailing Address
First Line	:	18017 BABLER FARMS LN
Second Line	:
City	:	WILDWOOD
State	:	MO
Zip	:	63005-6239
Country	:	US
Telephone Number	:	314-620-1997
Fax Number	:

Provider Business Practice Location Address
First Line	:	6922 RIVERMONT TRL
Second Line	:
City	:	HOUSE SPRINGS
State	:	MO
Zip	:	63051-2027
Country	:	US
Telephone Number	:	636-671-3330
Fax Number	:

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

Provider Enumeration Date	:	08/22/2022
Last Update Date	:	08/22/2022

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