Provider Demographics
NPI:1851502355
Name:KRAAR, MARILYN R (LCSW)
Entity Type:Individual
Prefix:
First Name:MARILYN
Middle Name:R
Last Name:KRAAR
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4606 N OAKLAND AVE
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53211-1231
Mailing Address - Country:US
Mailing Address - Phone:414-332-3231
Mailing Address - Fax:414-771-9543
Practice Address - Street 1:4606 N OAKLAND AVE
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53211-1231
Practice Address - Country:US
Practice Address - Phone:414-332-3231
Practice Address - Fax:414-771-9543
Is Sole Proprietor?:No
Enumeration Date:2007-05-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI637-1231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical