Provider Demographics
NPI:1275301269
Name:KRASNER, BRACHA YEHUDIS
Entity Type:Individual
Prefix:
First Name:BRACHA
Middle Name:YEHUDIS
Last Name:KRASNER
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 1:3717 CLARINTH RD
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21215-2403
Mailing Address - Country:US
Mailing Address - Phone:443-453-3074
Mailing Address - Fax:
Practice Address - Street 1:6300 SMITH AVE
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21209-2714
Practice Address - Country:US
Practice Address - Phone:443-453-3074
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-19
Last Update Date:2023-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NA106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician