Provider Demographics
NPI:1619681004
Name:KRALIK, EMMA
Entity Type:Individual
Prefix:
First Name:EMMA
Middle Name:
Last Name:KRALIK
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 1:4282 E 50TH ST APT 6201
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50317-4852
Mailing Address - Country:US
Mailing Address - Phone:515-559-4329
Mailing Address - Fax:
Practice Address - Street 1:4282 E 50TH ST APT 6201
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50317-4852
Practice Address - Country:US
Practice Address - Phone:515-559-4329
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-10
Last Update Date:2023-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst