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1144751348
MARK DURHAM KROLL
WEST LAFAYETTE, IN
NPI
1144751348
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: IN 3300570A)
Enumeration Date
2017-03-21
Last Update Date
2017-03-21
Business Address
-- MARK DURHAM KROLL LSW
2435 KESTRAL BLVD APT D
WEST LAFAYETTE, IN 47906-6702
Phone number: 765-543-0478
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Mailing Address
-- MARK DURHAM KROLL LSW
2435 KESTRAL BLVD APT D
WEST LAFAYETTE, IN 47906-6702
Phone number: 765-543-0478
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