Provider Demographics
NPI:1053591412
Name:SHRAGE, ELEANOR KRANZ (CEIS,MSW)
Entity type:Individual
Prefix:MRS
First Name:ELEANOR
Middle Name:KRANZ
Last Name:SHRAGE
Suffix:
Gender:F
Credentials:CEIS,MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:411 WAVERLY OAKS RD
Mailing Address - Street 2:
Mailing Address - City:WALTHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02452-8448
Mailing Address - Country:US
Mailing Address - Phone:781-894-6564
Mailing Address - Fax:
Practice Address - Street 1:411 WAVERLY OAKS RD
Practice Address - Street 2:
Practice Address - City:WALTHAM
Practice Address - State:MA
Practice Address - Zip Code:02452-8448
Practice Address - Country:US
Practice Address - Phone:781-894-6564
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-13
Last Update Date:2007-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist