Individual
MRS. KRISTEN CAROLYN KILLACKEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
21520 PIONEER BLVD STE 110, HAWAIIAN GARDENS, CA 90716-2603
(562) 865-3644
Mailing address
14261 BROWNING AVE APT 8, TUSTIN, CA 92780-6380
(714) 730-8431
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Enumeration date
03/06/2007
Last updated
07/08/2007
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