Provider Demographics
NPI:1396827432
Name:KRAMER, GRETA JOAN (LMFT)
Entity Type:Individual
Prefix:
First Name:GRETA
Middle Name:JOAN
Last Name:KRAMER
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3333 W DIVISION ST STE 119
Mailing Address - Street 2:
Mailing Address - City:SAINT CLOUD
Mailing Address - State:MN
Mailing Address - Zip Code:56301-4548
Mailing Address - Country:US
Mailing Address - Phone:320-493-9999
Mailing Address - Fax:320-774-1624
Practice Address - Street 1:3333 W DIVISION ST STE 119
Practice Address - Street 2:
Practice Address - City:SAINT CLOUD
Practice Address - State:MN
Practice Address - Zip Code:56301-4548
Practice Address - Country:US
Practice Address - Phone:320-493-9999
Practice Address - Fax:320-774-1621
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-19
Last Update Date:2024-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1263106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN485483700Medicaid