Provider Demographics
NPI:1336256866
Name:KRANTZ, JUDITH Z (PHD)
Entity Type:Individual
Prefix:DR
First Name:JUDITH
Middle Name:Z
Last Name:KRANTZ
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5018 DORSEY HALL DR
Mailing Address - Street 2:#205
Mailing Address - City:ELLICOTT CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21042
Mailing Address - Country:US
Mailing Address - Phone:410-730-9022
Mailing Address - Fax:410-740-3666
Practice Address - Street 1:5018 DORSEY HALL DR
Practice Address - Street 2:SUITE 205
Practice Address - City:ELLICOTT CITY
Practice Address - State:MD
Practice Address - Zip Code:21042
Practice Address - Country:US
Practice Address - Phone:410-730-9022
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDMARYLAND2136103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist