Provider Demographics
NPI:1871091363
Name:KROHN, MARGARET ANN (ABAIN10188929)
Entity type:Individual
Prefix:
First Name:MARGARET
Middle Name:ANN
Last Name:KROHN
Suffix:
Gender:F
Credentials:ABAIN10188929
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 E 3RD ST STE 101
Mailing Address - Street 2:
Mailing Address - City:THE DALLES
Mailing Address - State:OR
Mailing Address - Zip Code:97058-2563
Mailing Address - Country:US
Mailing Address - Phone:541-298-2101
Mailing Address - Fax:
Practice Address - Street 1:2250 ASH ST
Practice Address - Street 2:
Practice Address - City:BAKER CITY
Practice Address - State:OR
Practice Address - Zip Code:97814-2936
Practice Address - Country:US
Practice Address - Phone:541-519-1043
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-30
Last Update Date:2018-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORABAIN10188929106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician