Individual
MARK J KILGALLON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LICSW
Contact information
Practice address
60 TERRACE ST, BRATTLEBORO, VT 05301-3105
(413) 522-9158
Mailing address
60 TERRACE ST, BRATTLEBORO, VT 05301-3105
(413) 522-9158
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
212047
MA
Other
Enumeration date
02/20/2007
Last updated
03/20/2023
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