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General NPI Number Information
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NPI Number | 1639941768
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Entity Type | Individual
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Provider Name | KRISTEN ANN ROOF M.ED, C.A.G.S
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Gender | Female
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Dates
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Enumeration Date | 10/23/2023
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Last Update Date | 10/23/2023
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Provider Practice Location Address
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Address Line | 1900 PURDY AVE
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City | MIAMI BEACH
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State | FL
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Zip | 33139-1400
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Country | US
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Telephone | 203-434-0266
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Fax |
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Provider Business Mailing Address
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Address Line | 1900 PURDY AVE APT 1910
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City | MIAMI BEACH
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State | FL
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Zip | 33139-1492
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Country | US
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Telephone | 203-434-0266
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TS0200X
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Taxonomy Name | School Psychologist
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License Number | 312149
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License Number State | MA
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