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NPI Code Detail

MEDICARE: GRACE KRUEGER

MEDICARE: GRACE KRUEGER
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
1103K00000XBehavior Analyst
2101YP2500XProfessional Counselor97638TX

General Provider Information

NPI Number : 1649836107
Entity Type Code : Individual
Provider Name (Legal Business Name) : GRACE KRUEGER
Provider Business Mailing Address
First Line : 7008 RAINTREE PL
Second Line :
City : FLOWER MOUND
State : TX
Zip : 75022-6151
Country : US
Telephone Number : 940-536-9866
Fax Number :
Provider Business Practice Location Address
First Line : 161 W 3RD ST STE 100
Second Line :
City : PROSPER
State : TX
Zip : 75078-2906
Country : US
Telephone Number : 844-824-8775
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/10/2019
Last Update Date : 01/06/2026

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Directions to “ GRACE KRUEGER ” Practice Location

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