Provider Demographics
NPI:1386852713
Name:KRAMER, KATHLEEN LAURA (SLP)
Entity Type:Individual
Prefix:MRS
First Name:KATHLEEN
Middle Name:LAURA
Last Name:KRAMER
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1007 SAINT ANDREWS DR
Mailing Address - Street 2:
Mailing Address - City:UNION
Mailing Address - State:MO
Mailing Address - Zip Code:63084-4497
Mailing Address - Country:US
Mailing Address - Phone:636-583-3205
Mailing Address - Fax:
Practice Address - Street 1:875 DUNSFORD DR
Practice Address - Street 2:
Practice Address - City:SULLIVAN
Practice Address - State:MO
Practice Address - Zip Code:63080-1238
Practice Address - Country:US
Practice Address - Phone:573-468-3128
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2005001997235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist