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NPI Code Detail

MEDICARE: AALIYAH M KILBOURNE

MEDICARE: AALIYAH M KILBOURNE
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1639774920
Entity Type Code : Individual
Provider Name (Legal Business Name) : AALIYAH M KILBOURNE
Provider Business Mailing Address
First Line : 1486 DONEGAL DR
Second Line :
City : MELBOURNE
State : FL
Zip : 32940-6057
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2740 N HARBOR CITY BLVD
Second Line :
City : MELBOURNE
State : FL
Zip : 32935-6291
Country : US
Telephone Number : 321-622-6884
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/03/2020
Last Update Date : 12/03/2020

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Directions to “ AALIYAH M KILBOURNE ” Practice Location

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