Provider Demographics
NPI:1740540004
Name:KAMEN, KATHLEEN A (MSS)
Entity type:Individual
Prefix:MS
First Name:KATHLEEN
Middle Name:A
Last Name:KAMEN
Suffix:
Gender:F
Credentials:MSS
Other - Prefix:
Other - First Name:KATHLEEN
Other - Middle Name:A
Other - Last Name:SQUILLANTE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2407 LARKWOOD DR
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19810-2605
Mailing Address - Country:US
Mailing Address - Phone:302-475-2998
Mailing Address - Fax:
Practice Address - Street 1:5610 KIRKWOOD HWY
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19808-5004
Practice Address - Country:US
Practice Address - Phone:302-636-0700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-21
Last Update Date:2012-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW128938104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker