Provider Demographics
NPI:1063922474
Name:KILSON, JULIANNE (PLPC)
Entity type:Individual
Prefix:
First Name:JULIANNE
Middle Name:
Last Name:KILSON
Suffix:
Gender:F
Credentials:PLPC
Other - Prefix:
Other - First Name:JULES
Other - Middle Name:
Other - Last Name:KILSON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:14108 JESSE JAMES FARM RD
Mailing Address - Street 2:
Mailing Address - City:KEARNEY
Mailing Address - State:MO
Mailing Address - Zip Code:64060-9008
Mailing Address - Country:US
Mailing Address - Phone:816-622-3171
Mailing Address - Fax:
Practice Address - Street 1:112 WESTWOODS DR
Practice Address - Street 2:
Practice Address - City:LIBERTY
Practice Address - State:MO
Practice Address - Zip Code:64068-1181
Practice Address - Country:US
Practice Address - Phone:816-412-0454
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-11
Last Update Date:2023-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
MO2016001750101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health