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Individual
JACQUELINE YOUNG MCKILLOP
Active
Individual
JACQUELINE YOUNG MCKILLOP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
014468-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00355344
—
NY
01
—
11716304
CAQH
NY
01
—
BA0135
PTAN
—
Enumeration date
02/27/2007
Last updated
07/31/2013
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