Provider Demographics
NPI:1821376906
Name:KRASON, KATIE ANNE (EDM)
Entity Type:Individual
Prefix:MRS
First Name:KATIE
Middle Name:ANNE
Last Name:KRASON
Suffix:
Gender:F
Credentials:EDM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 FORESTER DR
Mailing Address - Street 2:
Mailing Address - City:BARNEGAT
Mailing Address - State:NJ
Mailing Address - Zip Code:08005-2225
Mailing Address - Country:US
Mailing Address - Phone:908-295-9697
Mailing Address - Fax:
Practice Address - Street 1:15 FORESTER DR
Practice Address - Street 2:
Practice Address - City:BARNEGAT
Practice Address - State:NJ
Practice Address - Zip Code:08005-2225
Practice Address - Country:US
Practice Address - Phone:908-295-9697
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-24
Last Update Date:2011-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst