Provider Demographics
NPI:1801852918
Name:KROLL, DARLENE JANE (LMT, EMT, RMA)
Entity Type:Individual
Prefix:MS
First Name:DARLENE
Middle Name:JANE
Last Name:KROLL
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Gender:F
Credentials:LMT, EMT, RMA
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Mailing Address - Street 1:1771 GULFSTREAM AVE
Mailing Address - Street 2:C4
Mailing Address - City:FORT PIERCE
Mailing Address - State:FL
Mailing Address - Zip Code:34949-3517
Mailing Address - Country:US
Mailing Address - Phone:772-461-4004
Mailing Address - Fax:772-461-2242
Practice Address - Street 1:1771 GULFSTREAM AVE
Practice Address - Street 2:C4
Practice Address - City:FORT PIERCE
Practice Address - State:FL
Practice Address - Zip Code:34949-3517
Practice Address - Country:US
Practice Address - Phone:772-461-4004
Practice Address - Fax:772-461-2242
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-26
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLMA41235225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist