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General NPI Number Information
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NPI Number | 1417041443
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Entity Type | Individual
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Provider Name | HEATHER LEE KILROY MA, LPC
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Gender | Female
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Dates
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Enumeration Date | 10/03/2006
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 3580 INDIAN QUEEN LANE
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City | PHILADELPHIA
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State | PA
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Zip | 19129
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Country | US
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Telephone | 267-975-4426
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Fax | 267-331-6822
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Provider Business Mailing Address
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Address Line | 3580 INDIAN QUEEN LANE
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City | PHILA.
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State | PA
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Zip | 19129
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Country | US
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Telephone | 267-975-4426
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Fax | 267-331-6822
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number | PC002345
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | PC002345
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License Number State | PA
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