Individual
MS. TARA LEIGH KROG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
2916 E PIERCE, PHOENIX, AZ 85004
(602) 344-5982
(480) 344-2114
Mailing address
2601 E. ROOSEVELT, PHOENIX, AZ 85004
(602) 344-5982
(480) 344-2214
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
4025
AZ
Other
Enumeration date
11/09/2006
Last updated
10/07/2011
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