MEDICARE: RACHEL RABINOWITZ KRASNER LMSW

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	101Y00000X	Counselor	MSW006974	GA

General Provider Information

NPI Number	:	1700255593
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RACHEL RABINOWITZ KRASNER LMSW

Provider Business Mailing Address
First Line	:	171 VILLAGE PKWY NE
Second Line	:	BUILDING 8A
City	:	MARIETTA
State	:	GA
Zip	:	30067-4061
Country	:	US
Telephone Number	:	404-520-1762
Fax Number	:

Provider Business Practice Location Address
First Line	:	171 VILLAGE PKWY NE
Second Line	:	BUILDING 8A
City	:	MARIETTA
State	:	GA
Zip	:	30067-4061
Country	:	US
Telephone Number	:	404-520-1762
Fax Number	:

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

Provider Enumeration Date	:	09/22/2015
Last Update Date	:	11/04/2016

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