Provider Demographics
NPI:1932293321
Name:CRAMER, MARIANNE (MS CCC A)
Entity Type:Individual
Prefix:
First Name:MARIANNE
Middle Name:
Last Name:CRAMER
Suffix:
Gender:F
Credentials:MS CCC A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 26666
Mailing Address - Street 2:PHS PROVIDER ENROLLMENT
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87125-6666
Mailing Address - Country:US
Mailing Address - Phone:505-923-5356
Mailing Address - Fax:505-923-5654
Practice Address - Street 1:1202 HIGHWAY 60
Practice Address - Street 2:SOCORRO GENERAL HOSPITAL
Practice Address - City:SOCORRO
Practice Address - State:NM
Practice Address - Zip Code:87801-3914
Practice Address - Country:US
Practice Address - Phone:505-835-1140
Practice Address - Fax:505-835-8716
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2008-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM2526231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist