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General NPI Number Information
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NPI Number | 1912054636
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Entity Type | Individual
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Provider Name | ROSEMARY KROLL MA, LPC
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Gender | Female
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Dates
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Enumeration Date | 01/04/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 4008 W WACKERLY ST
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City | MIDLAND
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State | MI
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Zip | 48640-1800
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Country | US
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Telephone | 989-633-9021
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Fax | 989-633-9026
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Provider Business Mailing Address
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Address Line | 4515 N VERITY RD
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City | SANFORD
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State | MI
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Zip | 48657-9389
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Country | US
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Telephone | 989-687-2737
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 6401005668
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License Number State | MI
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