MEDICARE: EVE KILMER PHD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103T00000X	Psychologist	2662	CO

General Provider Information

NPI Number	:	1184645202
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EVE KILMER PHD

Provider Business Mailing Address
First Line	:	4770 BASELINE RD
Second Line	:	SUITE 315
City	:	BOULDER
State	:	CO
Zip	:	80303-2666
Country	:	US
Telephone Number	:	303-995-9922
Fax Number	:

Provider Business Practice Location Address
First Line	:	4770 BASELINE RD
Second Line	:	SUITE 315
City	:	BOULDER
State	:	CO
Zip	:	80303-2666
Country	:	US
Telephone Number	:	303-995-9922
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/22/2006
Last Update Date	:	02/23/2010

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