Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 102L00000X | Psychologist | ||
N | 103T00000X | Psychologist | ||
Y | 225C00000X | Rehabilitation Counselor |
NPI | 1154932226 |
---|---|
Provider Name | David Krom |
First Address | Los Angeles, CA 90034-3740 |
Second Address | Los Angeles, CA 90034-3740 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/08/2020 |
Last Update Date | 31/08/2020 |