Individual
KELLY KROCKEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
500 BI COUNTY BLVD STE 450, FARMINGDALE, NY 11735-3995
(718) 264-1640
Mailing address
52 KING ST, KINGS PARK, NY 11754-2527
(631) 782-5238
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
03/16/2023
Last updated
03/16/2023
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