Provider Demographics
NPI:1225182223
Name:KILMER, ANNA DWYER (MED, NCC, LPC, CAADC)
Entity Type:Individual
Prefix:MS
First Name:ANNA
Middle Name:DWYER
Last Name:KILMER
Suffix:
Gender:F
Credentials:MED, NCC, LPC, CAADC
Other - Prefix:MS
Other - First Name:ANNA
Other - Middle Name:DWYER
Other - Last Name:SKINNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:650 N CANNON AVE # 112
Mailing Address - Street 2:
Mailing Address - City:LANSDALE
Mailing Address - State:PA
Mailing Address - Zip Code:19446-1874
Mailing Address - Country:US
Mailing Address - Phone:267-458-2927
Mailing Address - Fax:267-291-6468
Practice Address - Street 1:650 N CANNON AVE # 112
Practice Address - Street 2:
Practice Address - City:LANSDALE
Practice Address - State:PA
Practice Address - Zip Code:19446-1874
Practice Address - Country:US
Practice Address - Phone:267-458-2927
Practice Address - Fax:267-291-6468
Is Sole Proprietor?:No
Enumeration Date:2007-01-23
Last Update Date:2024-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC006991101YP2500X
PAPC014125101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1444XOtherBCBS
NC6103535Medicaid