Provider Demographics
NPI:1720545700
Name:KILMER, CAITLIN (PSYD)
Entity Type:Individual
Prefix:DR
First Name:CAITLIN
Middle Name:
Last Name:KILMER
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:226 HONEY LOCUST DR
Mailing Address - Street 2:
Mailing Address - City:AVONDALE
Mailing Address - State:PA
Mailing Address - Zip Code:19311-9804
Mailing Address - Country:US
Mailing Address - Phone:610-457-9880
Mailing Address - Fax:
Practice Address - Street 1:100 S BROAD ST STE 1700
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19110-1007
Practice Address - Country:US
Practice Address - Phone:215-701-1560
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-26
Last Update Date:2019-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPSS018574103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist