Provider Demographics
NPI:1063532950
Name:KALIL, MARY ANNE (LMSW)
Entity type:Individual
Prefix:MS
First Name:MARY
Middle Name:ANNE
Last Name:KALIL
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4655 N COMMERCE DR
Mailing Address - Street 2:
Mailing Address - City:SIERRA VISTA
Mailing Address - State:AZ
Mailing Address - Zip Code:85635-2497
Mailing Address - Country:US
Mailing Address - Phone:520-459-3012
Mailing Address - Fax:520-459-3207
Practice Address - Street 1:4525 CAMPUS DR
Practice Address - Street 2:
Practice Address - City:SIERRA VISTA
Practice Address - State:AZ
Practice Address - Zip Code:85635-2232
Practice Address - Country:US
Practice Address - Phone:520-459-3011
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-02
Last Update Date:2015-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical