Provider Demographics
NPI:1689837866
Name:KROL, KATHLEEN (PHD)
Entity Type:Individual
Prefix:DR
First Name:KATHLEEN
Middle Name:
Last Name:KROL
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 595
Mailing Address - Street 2:
Mailing Address - City:NEWFOUNDLAND
Mailing Address - State:NJ
Mailing Address - Zip Code:07435
Mailing Address - Country:US
Mailing Address - Phone:973-764-4847
Mailing Address - Fax:
Practice Address - Street 1:2713 ROUTE 23 SOUTH
Practice Address - Street 2:
Practice Address - City:NEWFOUNDLAND
Practice Address - State:NJ
Practice Address - Zip Code:07435
Practice Address - Country:US
Practice Address - Phone:973-764-4847
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-08
Last Update Date:2008-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ355100405000103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist