Provider Demographics
NPI:1942062153
Name:KILGORE, AALIYAH MORGAN
Entity Type:Individual
Prefix:
First Name:AALIYAH
Middle Name:MORGAN
Last Name:KILGORE
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 1:1641 4TH ST E
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55106-5405
Mailing Address - Country:US
Mailing Address - Phone:612-246-5573
Mailing Address - Fax:
Practice Address - Street 1:4638 VICTOR PATH STE 900
Practice Address - Street 2:
Practice Address - City:HUGO
Practice Address - State:MN
Practice Address - Zip Code:55038-4732
Practice Address - Country:US
Practice Address - Phone:651-364-3839
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-24
Last Update Date:2024-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional