Provider Demographics
NPI:1790414381
Name:ALPAUGH, KILEY
Entity Type:Individual
Prefix:
First Name:KILEY
Middle Name:
Last Name:ALPAUGH
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 1:1419 HANCOCK ST STE 200&202
Mailing Address - Street 2:
Mailing Address - City:QUINCY
Mailing Address - State:MA
Mailing Address - Zip Code:02169-5250
Mailing Address - Country:US
Mailing Address - Phone:617-770-9690
Mailing Address - Fax:
Practice Address - Street 1:1419 HANCOCK ST STE 200&202
Practice Address - Street 2:
Practice Address - City:QUINCY
Practice Address - State:MA
Practice Address - Zip Code:02169-5250
Practice Address - Country:US
Practice Address - Phone:617-770-9690
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-08
Last Update Date:2022-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health