Provider Demographics
NPI:1982281762
Name:KRATZER, ANN MARIE GORAL
Entity Type:Individual
Prefix:
First Name:ANN
Middle Name:MARIE GORAL
Last Name:KRATZER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ANN
Other - Middle Name:M
Other - Last Name:GORAL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPC
Mailing Address - Street 1:1185 SANDPIPER DR
Mailing Address - Street 2:
Mailing Address - City:OCONOMOWOC
Mailing Address - State:WI
Mailing Address - Zip Code:53066-2363
Mailing Address - Country:US
Mailing Address - Phone:262-354-5060
Mailing Address - Fax:
Practice Address - Street 1:1185 SANDPIPER DR
Practice Address - Street 2:
Practice Address - City:OCONOMOWOC
Practice Address - State:WI
Practice Address - Zip Code:53066-2363
Practice Address - Country:US
Practice Address - Phone:262-354-5060
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-26
Last Update Date:2021-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI6924-125101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional