Basic Information
| Provider Information | |||||||||
| NPI: | 1952392755 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KRATZ | ||||||||
| FirstName: | KRIS | ||||||||
| MiddleName: | E. | ||||||||
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| Credential: | PH.D., ABPP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 10474 W THUNDERBIRD BLVD | ||||||||
| Address2: | SUITE 200 | ||||||||
| City: | SUN CITY | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 853513023 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6239723800 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 10494 W THUNDERBIRD BLVD | ||||||||
| Address2: | SUITE 108 | ||||||||
| City: | SUN CITY | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 853513058 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6235236921 | ||||||||
| FaxNumber: | 6235838246 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/31/2005 | ||||||||
| LastUpdateDate: | 10/07/2009 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103T00000X | 3899 | AZ | N | Behavioral Health & Social Service Providers | Psychologist | 103G00000X | 3899 | AZ | Y | Behavioral Health & Social Service Providers | Clinical Neuropsychologist |
No ID Information.