Individual
KIMBERLY KROLL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
811 3RD ST, CARLTON, MN 55718-9228
(763) 689-5385
Mailing address
825 N 19TH AVE E, DULUTH, MN 55812-1133
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
101379
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
088H0O
NAHC BC INDIVIDUAL
MN
05
—
40902900
—
WI
01
—
530R8KR
BCBS
MN
01
—
6406076
NAHC MD INDIVIDUAL
MN
01
—
HP45791
HEALTH PARTNERS
MN
Enumeration date
09/27/2006
Last updated
07/09/2007
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