Provider Demographics
NPI:1669646840
Name:KRONENBERGER, ROBIN DIANE-RILLA (LAC, MAC, PT)
Entity Type:Individual
Prefix:MRS
First Name:ROBIN
Middle Name:DIANE-RILLA
Last Name:KRONENBERGER
Suffix:
Gender:F
Credentials:LAC, MAC, PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7768 CHATFIELD LN
Mailing Address - Street 2:
Mailing Address - City:ELLICOTT CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21043-7915
Mailing Address - Country:US
Mailing Address - Phone:410-379-0632
Mailing Address - Fax:
Practice Address - Street 1:5710 NEWBURY ST
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21209-3657
Practice Address - Country:US
Practice Address - Phone:443-676-1607
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-17
Last Update Date:2008-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDUO1410171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist