Individual
MRS. CANDIE KILLACKEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
350 SOUTH MAIN STREET, ST. ALBANS, VT 05478
(802) 526-4438
Mailing address
PO BOX 11, FAIRFAX, VT 05454-0011
(978) 526-4438
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
1017916
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
470068
TUFTS HEALTH PLAN
MA
Enumeration date
09/20/2005
Last updated
01/24/2023
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