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General NPI Number Information
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NPI Number | 1023473238
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Entity Type | Organization
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Legal Business Name | KDR SERVICES, LLC
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Dates
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Enumeration Date | 12/15/2015
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Last Update Date | 05/28/2025
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Provider Practice Location Address
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Address Line | 22 GORDON AVE
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City | LAWRENCE TOWNSHIP
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State | NJ
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Zip | 08648-1033
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Country | US
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Telephone | 609-844-0452
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 6573
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City | LAWRENCE TOWNSHIP
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State | NJ
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Zip | 08648-0573
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Country | US
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Telephone | 609-844-0452
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | KRISTINA RAGO SOLOMITA
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Credential |
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Telephone | 609-844-0452
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 44SC05537300
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License Number State | NJ
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