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General NPI Number Information
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NPI Number | 1053676999
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Entity Type | Individual
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Provider Name | KEVIN M KILLARNEY M. ED.
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Gender | Male
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Dates
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Enumeration Date | 07/06/2012
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Last Update Date | 11/17/2021
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Provider Practice Location Address
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Address Line | 61 INDUSTRIAL PARK RD
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City | PLYMOUTH
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State | MA
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Zip | 02360-7246
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Country | US
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Telephone | 508-503-5020
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Fax |
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Provider Business Mailing Address
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Address Line | 78 PARTING ROCK RD
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City | DUXBURY
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State | MA
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Zip | 02332-3214
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Country | US
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Telephone | 781-296-3878
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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