Provider Information for 1487888947
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SUSAN J RAIR KRUG MSW,LICSW
Sex: Female
NPI: 1487888947
Last Updated: 2023-07-17
Certification Date: 2023-07-17
Certification Date: 2023-07-17
Details
| Name | Value | ||||||||||||||||||||
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| NPI | 1487888947 | ||||||||||||||||||||
| Enumeration Date | 2009-05-12 | ||||||||||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||||||||||
| Sole Proprietor | NO | ||||||||||||||||||||
| Status | Active | ||||||||||||||||||||
| Mailing Address | 246 NORTHLAND DR STE 200 MEDINA, OH 44256-3440 United States Phone: 330-725-9195 | Fax: | ||||||||||||||||||||
| Primary Practice Address | 246 NORTHLAND DR STE 200 MEDINA, OH 44256-3440 United States Phone: 419-543-3737 | Fax: | ||||||||||||||||||||
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