Provider Demographics
NPI:1376661769
Name:KILBY, SUSAN D
Entity Type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:D
Last Name:KILBY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 LARCHMONT AVENUE
Mailing Address - Street 2:
Mailing Address - City:WATERBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06708
Mailing Address - Country:US
Mailing Address - Phone:203-753-4306
Mailing Address - Fax:203-753-5306
Practice Address - Street 1:34 MURRAY STREET
Practice Address - Street 2:FAMILY SERVICES OF GREATER WATERBURY
Practice Address - City:WATERBURY
Practice Address - State:CT
Practice Address - Zip Code:06710-1920
Practice Address - Country:US
Practice Address - Phone:203-756-8317
Practice Address - Fax:203-756-8310
Is Sole Proprietor?:No
Enumeration Date:2007-03-26
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical