Provider Demographics
NPI:1154861938
Name:GONZALEZ-KILDUFF, PAULA (MSW, LSW)
Entity Type:Individual
Prefix:
First Name:PAULA
Middle Name:
Last Name:GONZALEZ-KILDUFF
Suffix:
Gender:F
Credentials:MSW, LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1055 CETRONIA RD APT B14
Mailing Address - Street 2:
Mailing Address - City:BREINIGSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:18031-1695
Mailing Address - Country:US
Mailing Address - Phone:610-969-6154
Mailing Address - Fax:
Practice Address - Street 1:1055 CETRONIA RD APT B14
Practice Address - Street 2:
Practice Address - City:BREINIGSVILLE
Practice Address - State:PA
Practice Address - Zip Code:18031-1695
Practice Address - Country:US
Practice Address - Phone:610-969-6154
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-28
Last Update Date:2017-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW1265801041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical