| Doctor Name: | DR. GARY KILPELA |
| NPI Number: | 1306027057 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PSY.D. |
| License Number: | 6301013061 |
| Business Practice Address: | 301 West Lake Ave. Suite 2 Houghton, MI - 49931 |
| Business Phone Number: | 9062813459 |
| Business Fax Number: | |
| Mailing Address: | 301 West Lake Ave., Suite 2 HOUGHTON |
| State: | MI |
| Postal Code: | 49931 |
| Phone Number: | 9062813459 |
| Fax Number: | |
| NPI Enumeration Date: | 11/23/2007 |
| NPI Last Update Date: | 11/23/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC2200X |
| License Number: | 6301013061 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | MI |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical Child & Adolescent |
| Taxonomy Definition: | |