Provider Demographics
NPI:1790806818
Name:PRATT, KRINA ENNIS (PT)
Entity Type:Individual
Prefix:MRS
First Name:KRINA
Middle Name:ENNIS
Last Name:PRATT
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:47 BEECH GROVE RD
Mailing Address - Street 2:
Mailing Address - City:HONESDALE
Mailing Address - State:PA
Mailing Address - Zip Code:18431-4164
Mailing Address - Country:US
Mailing Address - Phone:570-253-1437
Mailing Address - Fax:
Practice Address - Street 1:ELLEN MEMORIAL HEALTH CARE CENTER
Practice Address - Street 2:23 ELLEN MEMORIAL LANE
Practice Address - City:HONESDALE
Practice Address - State:PA
Practice Address - Zip Code:18431
Practice Address - Country:US
Practice Address - Phone:570-253-5690
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-03
Last Update Date:2009-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT004063L225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist