Provider Demographics
NPI:1972570497
Name:KRAMER, ROZLIND X (PHD, LP)
Entity Type:Individual
Prefix:DR
First Name:ROZLIND
Middle Name:X
Last Name:KRAMER
Suffix:
Gender:F
Credentials:PHD, LP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3311 KNOB LN NW
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:MN
Mailing Address - Zip Code:55901-6909
Mailing Address - Country:US
Mailing Address - Phone:507-287-0455
Mailing Address - Fax:507-424-6321
Practice Address - Street 1:3265 19TH ST NW
Practice Address - Street 2:SUITE 350
Practice Address - City:ROCHESTER
Practice Address - State:MN
Practice Address - Zip Code:55901-6786
Practice Address - Country:US
Practice Address - Phone:507-287-0455
Practice Address - Fax:507-424-6321
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-02
Last Update Date:2015-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNLP1406103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN39434KROtherBCBS
MN760248100Medicaid
MN760248100Medicaid
MN760248100Medicaid