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General NPI Number Information
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NPI Number | 1891927398
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Entity Type | Individual
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Provider Name | NICOLE L. KROEBER LCSW
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Gender | Female
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Dates
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Enumeration Date | 08/17/2009
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Last Update Date | 05/16/2012
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Provider Practice Location Address
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Address Line | 925 ORONOKE RD UNIT 26H
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City | WATERBURY
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State | CT
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Zip | 06708-3976
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Country | US
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Telephone | 203-537-7133
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Fax |
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Provider Business Mailing Address
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Address Line | 925 ORONOKE RD UNIT 26H
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City | WATERBURY
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State | CT
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Zip | 06708-3976
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Country | US
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Telephone | 203-537-7133
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | 006776
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License Number State | CT
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