Provider Demographics
NPI:1023215274
Name:KRENZ, ROSANNA M (MED, MA)
Entity Type:Individual
Prefix:MS
First Name:ROSANNA
Middle Name:M
Last Name:KRENZ
Suffix:
Gender:F
Credentials:MED, MA
Other - Prefix:
Other - First Name:ROSANNA
Other - Middle Name:M
Other - Last Name:KRENZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPC
Mailing Address - Street 1:5748 SUNSTONE ST SE
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97306-3505
Mailing Address - Country:US
Mailing Address - Phone:503-585-4710
Mailing Address - Fax:
Practice Address - Street 1:225 MADRONA AVE SE
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97302-4609
Practice Address - Country:US
Practice Address - Phone:503-689-7011
Practice Address - Fax:503-588-9990
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-29
Last Update Date:2016-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health