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Individual
MS. LISA BAILEY KILROW
Active
Individual
MS. LISA BAILEY KILROW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
989104
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11238553
CAQH PROVIDER ID
CO
01
—
214487
VALUE OPTIONS PROVIDER
CO
01
—
989104
STATE LICENSE
CO
Enumeration date
02/01/2007
Last updated
07/08/2007
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