Provider Demographics
NPI:1881107340
Name:KRUL, KARISSA (MA, BS)
Entity type:Individual
Prefix:
First Name:KARISSA
Middle Name:
Last Name:KRUL
Suffix:
Gender:F
Credentials:MA, BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 FOXBOROUGH BLVD APT 6307
Mailing Address - Street 2:
Mailing Address - City:FOXBORO
Mailing Address - State:MA
Mailing Address - Zip Code:02035-3814
Mailing Address - Country:US
Mailing Address - Phone:248-321-0407
Mailing Address - Fax:
Practice Address - Street 1:140 PARK STREET
Practice Address - Street 2:3RD FLOOR
Practice Address - City:ATTLEBORO
Practice Address - State:MA
Practice Address - Zip Code:02703
Practice Address - Country:US
Practice Address - Phone:508-222-7525
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-11-07
Last Update Date:2017-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health