Provider Demographics
NPI:1275699431
Name:KRAFT, RACHEL RAE (PSYD)
Entity Type:Individual
Prefix:DR
First Name:RACHEL
Middle Name:RAE
Last Name:KRAFT
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:306 N DIVISION ST
Mailing Address - Street 2:
Mailing Address - City:POWELL
Mailing Address - State:WY
Mailing Address - Zip Code:82435-2208
Mailing Address - Country:US
Mailing Address - Phone:307-754-5687
Mailing Address - Fax:
Practice Address - Street 1:627 WYOMING AVE
Practice Address - Street 2:
Practice Address - City:POWELL
Practice Address - State:WY
Practice Address - Zip Code:82435-2523
Practice Address - Country:US
Practice Address - Phone:307-754-5687
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-29
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT0493119Medicaid