Provider Information for 1841745957
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CRYSTAL ERIKA-KROELLS DE KAM LPCC
Other Names:Former Name:CRYSTAL ERIKA KROELLS LPCCSex: Female
NPI: 1841745957
Last Updated: 2021-09-02
Certification Date: 2021-09-02
Certification Date: 2021-09-02
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1841745957 | ||||||||
| Enumeration Date | 2016-08-18 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | NO | ||||||||
| Status | Active | ||||||||
| Mailing Address | 3300 CENTURY AVE N WHITE BEAR LAKE, MN 55110-1842 United States Phone: 651-779-3313 | Fax: | ||||||||
| Primary Practice Address | 3300 CENTURY AVE N WHITE BEAR LAKE, MN 55110-1842 United States Phone: 651-779-3313 | Fax: | ||||||||
| Secondary Practice Address(es) | 5958 FOREST BOULEVARD TRL | ||||||||
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