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Individual
WILLIAM R KILLGORE JR.
Active
Individual
WILLIAM R KILLGORE JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPC
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
PC002979
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
587349000
MAGELLAN BEHAVIORAL HEALT
PA
Enumeration date
01/17/2007
Last updated
05/04/2015
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