Provider Demographics
NPI:1124808332
Name:KROB, BRYTTANI A (LPCC)
Entity type:Individual
Prefix:MISS
First Name:BRYTTANI
Middle Name:A
Last Name:KROB
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:727 E 5TH AVE APT 2
Mailing Address - Street 2:
Mailing Address - City:DURANGO
Mailing Address - State:CO
Mailing Address - Zip Code:81301-5368
Mailing Address - Country:US
Mailing Address - Phone:970-739-4539
Mailing Address - Fax:
Practice Address - Street 1:727 E 5TH AVE APT 2
Practice Address - Street 2:
Practice Address - City:DURANGO
Practice Address - State:CO
Practice Address - Zip Code:81301-5368
Practice Address - Country:US
Practice Address - Phone:970-739-4539
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-04
Last Update Date:2023-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0020800101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health