Provider Demographics
NPI:1962675785
Name:REBECCA KRAATZ PLLC
Entity Type:Organization
Organization Name:REBECCA KRAATZ PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:KRAATZ
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:361-643-6213
Mailing Address - Street 1:118 SABINE ST
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:TX
Mailing Address - Zip Code:78374-1454
Mailing Address - Country:US
Mailing Address - Phone:361-643-1263
Mailing Address - Fax:
Practice Address - Street 1:2051 W WHEELER AVE UNIT 5
Practice Address - Street 2:
Practice Address - City:ARANSAS PASS
Practice Address - State:TX
Practice Address - Zip Code:78336-4765
Practice Address - Country:US
Practice Address - Phone:361-643-1263
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-13
Last Update Date:2008-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX33490251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health