Individual
MR. KEVIN JAMES MOYER-WILKES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.ED., NCC
Contact information
Practice address
1 ELMWOOD PL, BOYLSTON, MA 01505-2040
(508) 869-0197
(508) 869-0313
Mailing address
16 SAXON RD, WORCESTER, MA 01602-1522
(508) 869-0197
(508) 869-0313
Taxonomy
Speciality
Code
Description
License number
State
101YS0200X
School Counselor
10606058
PA
101YS0200X
School Counselor
463166
MA
101YS0200X
School Counselor
C062011002701
CT
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
—
MA
Other
Enumeration date
01/16/2013
Last updated
01/16/2013
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