Provider Demographics
NPI:1235685447
Name:KRAUS, KEAH
Entity Type:Individual
Prefix:
First Name:KEAH
Middle Name:
Last Name:KRAUS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12505 STARKEY RD STE JK
Mailing Address - Street 2:
Mailing Address - City:LARGO
Mailing Address - State:FL
Mailing Address - Zip Code:33773-2621
Mailing Address - Country:US
Mailing Address - Phone:727-280-6643
Mailing Address - Fax:888-972-6190
Practice Address - Street 1:12505 STARKEY RD STE JK
Practice Address - Street 2:
Practice Address - City:LARGO
Practice Address - State:FL
Practice Address - Zip Code:33773-2621
Practice Address - Country:US
Practice Address - Phone:727-280-6643
Practice Address - Fax:888-972-6190
Is Sole Proprietor?:No
Enumeration Date:2016-08-28
Last Update Date:2019-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL0178373103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst