Provider Demographics
NPI:1255876579
Name:WILL, KAYLEE E (MA)
Entity type:Individual
Prefix:
First Name:KAYLEE
Middle Name:E
Last Name:WILL
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2835 BLUFF RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:QUINCY
Mailing Address - State:IL
Mailing Address - Zip Code:62305-1391
Mailing Address - Country:US
Mailing Address - Phone:217-440-2966
Mailing Address - Fax:
Practice Address - Street 1:205 S 24TH ST
Practice Address - Street 2:
Practice Address - City:QUINCY
Practice Address - State:IL
Practice Address - Zip Code:62301-4446
Practice Address - Country:US
Practice Address - Phone:217-222-0034
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-12-21
Last Update Date:2016-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health