Mark Durham Kroll, LSW

NPI #1144751348 in West Lafayette, Indiana

Provider Information

NPI Number: 1144751348
Entity Type: Individual
Name: Mark Durham Kroll, LSW
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Counselor - Addiction (Substance Use Disorder)
Credential: LSW
Enumeration Date: Mar 21, 2017
Last Updated: Mar 21, 2017

Practice Location

Address: 2435 KESTRAL BLVD APT D
City: West Lafayette
State: Indiana
ZIP Code: 47906-6702
Phone: (765) 543-0478

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor - Addiction (Substance Use Disorder) — Addiction (Substance Use Disorder)	101YA0400X	Primary

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