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Individual

DR. NANCY E KILLIAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PH.D.

Contact information

Practice address
1241 POST RD, FAIRFIELD, CT 06824-6025
(203) 319-0236
(203) 319-0236
Mailing address
PO BOX 831, FAIRFIELD, CT 06824-0831
(203) 319-0236
(203) 319-0236

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
060002078
CT
103TC1900X
Counseling Psychologist
002078
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
060002078CT01
ANTHEM PROVIDER ID
CT
01
336733
VALUE OPTIONS PROVIDER #
CT
Enumeration date
03/14/2007
Last updated
09/02/2011
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