Individual
MARK DURHAM KROLL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LSW
Contact information
Practice address
2435 KESTRAL BLVD APT D, WEST LAFAYETTE, IN 47906-6702
(765) 543-0478
(866) 406-5077
Mailing address
2435 KESTRAL BLVD APT D, WEST LAFAYETTE, IN 47906-6702
(765) 543-0478
(866) 406-5077
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
3300570A
IN
Other
Enumeration date
03/21/2017
Last updated
03/21/2017
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