Provider Demographics
NPI:1043462468
Name:KRAFFT, REENI RIDER (MA, CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:REENI
Middle Name:RIDER
Last Name:KRAFFT
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2132 PRESIDIO CT APT 1
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:94526-6248
Mailing Address - Country:US
Mailing Address - Phone:443-764-4695
Mailing Address - Fax:
Practice Address - Street 1:2132 PRESIDIO CT
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:CA
Practice Address - Zip Code:94526-6248
Practice Address - Country:US
Practice Address - Phone:443-764-4695
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-16
Last Update Date:2019-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD05684235Z00000X
CA24609235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist