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General NPI Number Information
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NPI Number | 1629891999
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Entity Type | Individual
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Provider Name | DANIELLE ALICIA KILKENNY M.ED., B.S.
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Gender | Female
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Dates
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Enumeration Date | 11/05/2024
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Last Update Date | 11/05/2024
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Provider Practice Location Address
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Address Line | 5650 S WASHINGTON AVE
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City | TITUSVILLE
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State | FL
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Zip | 32780-7312
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Country | US
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Telephone | 321-383-5594
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Fax |
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Provider Business Mailing Address
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Address Line | 4589 CAMBERLY ST
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City | COCOA
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State | FL
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Zip | 32927-7961
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Country | US
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Telephone | 321-594-1764
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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 | 171W00000X
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Taxonomy Name | Contractor
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License Number |
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License Number State |
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