Individual
DR. LISA A KROCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ED.D.
Contact information
Practice address
24 ROCKLAND ST, HANOVER, MA 02339-2226
(781) 826-8228
(781) 826-0965
Mailing address
438 POND ST, WESTWOOD, MA 02090-2831
(781) 826-8228
(781) 826-0965
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
3003
MA
103TA0400X
Addiction (Substance Use Disorder) Psychologist
3003
MA
103TA0700X
Adult Development & Aging Psychologist
3003
MA
103TC0700X
Clinical Psychologist
Primary
3003
MA
103TC2200X
Clinical Child & Adolescent Psychologist
3003
MA
103TF0000X
Family Psychologist
3003
MA
103TF0200X
Forensic Psychologist
3003
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0510629
—
MA
Enumeration date
12/12/2006
Last updated
09/07/2007
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