Provider Demographics
NPI:1235633736
Name:CRAMER, STEPHAN WILLIAM
Entity Type:Individual
Prefix:
First Name:STEPHAN
Middle Name:WILLIAM
Last Name:CRAMER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1595 MONTELLO ST
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89512-2517
Mailing Address - Country:US
Mailing Address - Phone:775-313-7036
Mailing Address - Fax:
Practice Address - Street 1:5275 VISTA BLVD STE A1
Practice Address - Street 2:
Practice Address - City:SPARKS
Practice Address - State:NV
Practice Address - Zip Code:89436-0840
Practice Address - Country:US
Practice Address - Phone:775-420-5073
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-20
Last Update Date:2018-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst