Provider Demographics
NPI:1457079790
Name:KRAEMER, MADISON MARIA (MS, CF-SLP)
Entity Type:Individual
Prefix:MISS
First Name:MADISON
Middle Name:MARIA
Last Name:KRAEMER
Suffix:
Gender:F
Credentials:MS, CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18017 BABLER FARMS LN
Mailing Address - Street 2:
Mailing Address - City:WILDWOOD
Mailing Address - State:MO
Mailing Address - Zip Code:63005-6239
Mailing Address - Country:US
Mailing Address - Phone:314-620-1997
Mailing Address - Fax:
Practice Address - Street 1:6922 RIVERMONT TRL
Practice Address - Street 2:
Practice Address - City:HOUSE SPRINGS
Practice Address - State:MO
Practice Address - Zip Code:63051-2027
Practice Address - Country:US
Practice Address - Phone:636-671-3330
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-22
Last Update Date:2022-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2022032764235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist