Provider Demographics
NPI:1740653179
Name:KRAMER, THOMAS (PHD)
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:
Last Name:KRAMER
Suffix:
Gender:M
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:PO BOX 321
Mailing Address - Street 2:
Mailing Address - City:MENDON
Mailing Address - State:UT
Mailing Address - Zip Code:84325-0321
Mailing Address - Country:US
Mailing Address - Phone:801-979-0644
Mailing Address - Fax:
Practice Address - Street 1:95 S 100 E STE 300
Practice Address - Street 2:
Practice Address - City:PAYSON
Practice Address - State:UT
Practice Address - Zip Code:84651-2253
Practice Address - Country:US
Practice Address - Phone:801-382-9338
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-11-06
Last Update Date:2023-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103T00000X
UT9852542-2501103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist