Provider Demographics
NPI:1215024039
Name:KRAUS, WENDY SUE (MA)
Entity Type:Individual
Prefix:MISS
First Name:WENDY
Middle Name:SUE
Last Name:KRAUS
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2336 GODDARD PARKWAY
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:MD
Mailing Address - Zip Code:21801
Mailing Address - Country:US
Mailing Address - Phone:410-334-6961
Mailing Address - Fax:410-334-6960
Practice Address - Street 1:114 NORTH WASHINGTON ST
Practice Address - Street 2:SUITE 25 30
Practice Address - City:EASTON
Practice Address - State:MD
Practice Address - Zip Code:21601
Practice Address - Country:US
Practice Address - Phone:410-822-5007
Practice Address - Fax:410-822-5569
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDLM49EAOtherCAREFIRST BCBS (GROUP)
DCR968OtherCAREFIRST FEDERAL (GROUP)
517251OtherUHC MAMSI (GROUP)
MD742LMedicare ID - Type Unspecified