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General NPI Number Information
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NPI Number | 1073892808
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Entity Type | Individual
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Provider Name | CHAD KILLPACK PSY.D., ABPP
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Gender | Male
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Dates
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Enumeration Date | 08/10/2011
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Last Update Date | 07/23/2025
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Provider Practice Location Address
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Address Line | 86 HCOS/SGGK EPIC FLIGHT
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City | APO
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State | NY
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Zip | 09012
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Country | US
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Telephone | 314-479-2469
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Fax |
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Provider Business Mailing Address
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Address Line | 86 MDOS FLUGPLATZ RAMSTEIN GEB 2114
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City | APO
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State | AE
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Zip | 09012
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Country | US
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Telephone |
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number | PY 60340649
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License Number State | WA
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