Individual
DR. LARA IRENE KROODSMA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA,MS, PSYD
Contact information
Practice address
250 COMMERCIAL ST, SUITE 3004, MANCHESTER, NH 03101-1142
(603) 848-3387
(603) 668-8666
Mailing address
250 COMMERCIAL ST, SUITE 3004, MANCHESTER, NH 03101-1142
(603) 848-3387
(603) 668-8666
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
1189
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7706646Y0NH01
ANTHEM
NH
Enumeration date
02/06/2007
Last updated
09/28/2009
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