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General NPI Number Information
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NPI Number | 1255708608
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Entity Type | Individual
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Provider Name | MARY KILLMEYER D.M.F.T, L.M.F.T.
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Gender | Female
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Dates
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Enumeration Date | 09/01/2015
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Last Update Date | 01/04/2019
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Provider Practice Location Address
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Address Line | 1830 N PINE ISLAND RD
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City | PLANTATION
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State | FL
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Zip | 33322-5202
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Country | US
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Telephone | 954-609-8175
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Fax | 954-337-3722
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Provider Business Mailing Address
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Address Line | 1650 NW 100TH WAY
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City | PLANTATION
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State | FL
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Zip | 33322-6516
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Country | US
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Telephone | 954-609-8175
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | MT2678
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License Number State | FL
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