Provider Demographics
NPI:1851077838
Name:KROMKA, KAYLEIGH DEANNE
Entity type:Individual
Prefix:
First Name:KAYLEIGH
Middle Name:DEANNE
Last Name:KROMKA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:408 WILLOW RD.
Mailing Address - Street 2:
Mailing Address - City:HELLERTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18055
Mailing Address - Country:US
Mailing Address - Phone:484-541-2026
Mailing Address - Fax:
Practice Address - Street 1:40 S. 4TH ST.
Practice Address - Street 2:
Practice Address - City:EMMAUS
Practice Address - State:PA
Practice Address - Zip Code:18049
Practice Address - Country:US
Practice Address - Phone:610-762-8690
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-26
Last Update Date:2023-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC015850101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional