Luciana M Killam

Individual provider Active NPI Developmental Therapist · Groton, MA

NPI 1699524488 · NPPES record last updated May 15, 2024

Key facts

NPI
1699524488
Entity type
Individual (NPI type 1)
Primary specialty
Developmental Therapist 222Q00000X
Practice address
81A Kemp St
Groton, MA 01450-1125
Phone
(978) 328-3105
NPI assigned
May 15, 2024
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Developmental Therapist
Group: 193400000X SINGLE SPECIALTY GROUP
222Q00000X Yes

Addresses

Primary practice location

81A Kemp St
Groton, MA 01450-1125

Mailing address

81A Kemp St
Groton, MA 01450-1125
Phone (978) 328-3105

Other providers in Groton, MA

All providers in Groton, MA · Developmental Therapist in Massachusetts

Sources for this page

Verify at the official NPI Registry.