Provider Demographics
NPI:1730539859
Name:KROL, ALICIA (MS, BCBA)
Entity type:Individual
Prefix:
First Name:ALICIA
Middle Name:
Last Name:KROL
Suffix:
Gender:F
Credentials:MS, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:56 DANIEL DR
Mailing Address - Street 2:
Mailing Address - City:COLCHESTER
Mailing Address - State:CT
Mailing Address - Zip Code:06415-1964
Mailing Address - Country:US
Mailing Address - Phone:860-537-4697
Mailing Address - Fax:
Practice Address - Street 1:56 DANIEL DR
Practice Address - Street 2:
Practice Address - City:COLCHESTER
Practice Address - State:CT
Practice Address - Zip Code:06415-1964
Practice Address - Country:US
Practice Address - Phone:860-537-4697
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-20
Last Update Date:2016-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT1-15-20237103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst