Provider Information for 1952373243
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KRISTINA L MENZEL LCPC
Sex: Female
NPI: 1952373243
Last Updated: 2021-09-21
Certification Date: 2021-09-21
Certification Date: 2021-09-21
Details
Name | Value | ||||||||||||||||||||
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NPI | 1952373243 | ||||||||||||||||||||
Enumeration Date | 2006-02-02 | ||||||||||||||||||||
NPI Type | NPI-1 Individual | ||||||||||||||||||||
Sole Proprietor | NO | ||||||||||||||||||||
Status | Active | ||||||||||||||||||||
Mailing Address | 1717 FLETCHER ST PRINCETON, IL 61356-2609 United States Phone: 815-878-3926 | Fax: | ||||||||||||||||||||
Primary Practice Address | 530 PARK AVE E PRINCETON, IL 61356-3901 United States Phone: 815-876-2004 | Fax: | ||||||||||||||||||||
Secondary Practice Address(es) | 990 VILLA ST | ||||||||||||||||||||
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