Provider Demographics
NPI:1467877019
Name:KILMER, MEGAN LEIGH
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:LEIGH
Last Name:KILMER
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 1:1800 RULANE DR
Mailing Address - Street 2:
Mailing Address - City:MIDWEST CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73110-2561
Mailing Address - Country:US
Mailing Address - Phone:405-255-7466
Mailing Address - Fax:
Practice Address - Street 1:1800 RULANE DR
Practice Address - Street 2:
Practice Address - City:MIDWEST CITY
Practice Address - State:OK
Practice Address - Zip Code:73110-2561
Practice Address - Country:US
Practice Address - Phone:405-255-7466
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-19
Last Update Date:2014-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor