Provider Demographics
NPI:1720530165
Name:KRAFT, GUILEINE (PHD)
Entity Type:Individual
Prefix:DR
First Name:GUILEINE
Middle Name:
Last Name:KRAFT
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 1:15705 PEACH WALKER DR
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20716-1649
Mailing Address - Country:US
Mailing Address - Phone:301-613-6710
Mailing Address - Fax:
Practice Address - Street 1:15705 PEACH WALKER DR
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20716-1649
Practice Address - Country:US
Practice Address - Phone:301-613-6710
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-02
Last Update Date:2016-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD194761041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical