Provider Demographics
NPI:1063505048
Name:KILMER, KARLENE (PHD)
Entity Type:Individual
Prefix:DR
First Name:KARLENE
Middle Name:
Last Name:KILMER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:441 MANITOU AVE STE 201
Mailing Address - Street 2:
Mailing Address - City:MANITOU SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80829-2334
Mailing Address - Country:US
Mailing Address - Phone:719-460-7289
Mailing Address - Fax:719-623-0657
Practice Address - Street 1:441 MANITOU AVE STE 201
Practice Address - Street 2:
Practice Address - City:MANITOU SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80829-2334
Practice Address - Country:US
Practice Address - Phone:719-460-7289
Practice Address - Fax:719-623-0657
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-02
Last Update Date:2016-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM0890103TC0700X
CO3448103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical