| Doctor Name: | WILLIAM R KILLGORE |
| NPI Number: | 1639221237 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | LPC |
| License Number: | PC002979 |
| Business Practice Address: | 35 E Green St Nanticoke, PA - 186342414 |
| Business Phone Number: | 5707622583 |
| Business Fax Number: | 5703002629 |
| Mailing Address: | 35 E Green St, NANTICOKE |
| State: | PA |
| Postal Code: | 186342414 |
| Phone Number: | 5707622583 |
| Fax Number: | 5703002629 |
| NPI Enumeration Date: | 01/17/2007 |
| NPI Last Update Date: | 05/04/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | PC002979 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |