Doctor Name: | DIANA LYNNE KRAFT |
NPI Number: | 1154511749 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LCPC |
License Number: | LC1273 |
Business Practice Address: | 1295 Hollidge Rd Lusby, MD - 206572682 |
Business Phone Number: | 4102312124 |
Business Fax Number: | 4108821079 |
Mailing Address: | 1295 Hollidge Rd, LUSBY |
State: | MD |
Postal Code: | 206572682 |
Phone Number: | 4102312124 |
Fax Number: | 4108821079 |
NPI Enumeration Date: | 07/30/2007 |
NPI Last Update Date: | 06/17/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | LC1273 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MD |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |