Provider Demographics
NPI:1003628512
Name:KRAEMER, WENDY SUE (BCBA)
Entity type:Individual
Prefix:
First Name:WENDY
Middle Name:SUE
Last Name:KRAEMER
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5452 THOMPSON HILL RD
Mailing Address - Street 2:
Mailing Address - City:GILLETT
Mailing Address - State:PA
Mailing Address - Zip Code:16925-9356
Mailing Address - Country:US
Mailing Address - Phone:570-369-3019
Mailing Address - Fax:
Practice Address - Street 1:5452 THOMPSON HILL RD
Practice Address - Street 2:
Practice Address - City:GILLETT
Practice Address - State:PA
Practice Address - Zip Code:16925-9356
Practice Address - Country:US
Practice Address - Phone:570-369-3019
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-22
Last Update Date:2025-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA1-23-69077103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty