| Doctor Name: | DR. KATHLEEN JANDERNOA CRAMER |
| NPI Number: | 1083765812 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PHD, L.P. |
| License Number: | 6301013342 |
| Business Practice Address: | 967 Spaulding Ave Se Ada, MI - 493013700 |
| Business Phone Number: | 6164643424 |
| Business Fax Number: | 6169495336 |
| Mailing Address: | 4205 Baywood Dr Se, GRAND RAPIDS |
| State: | MI |
| Postal Code: | 495462288 |
| Phone Number: | 6169577807 |
| Fax Number: | 6169495336 |
| NPI Enumeration Date: | 01/16/2007 |
| NPI Last Update Date: | 11/23/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | 6301013342 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MI |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |