Provider Demographics
NPI:1528458494
Name:MCGUIGAN, KELLY
Entity type:Individual
Prefix:
First Name:KELLY
Middle Name:
Last Name:MCGUIGAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:479 THOMAS JONES WAY
Mailing Address - Street 2:SUITE 800
Mailing Address - City:EXTON
Mailing Address - State:PA
Mailing Address - Zip Code:19341-2580
Mailing Address - Country:US
Mailing Address - Phone:484-456-8247
Mailing Address - Fax:
Practice Address - Street 1:479 THOMAS JONES WAY
Practice Address - Street 2:SUITE 800
Practice Address - City:EXTON
Practice Address - State:PA
Practice Address - Zip Code:19341-2580
Practice Address - Country:US
Practice Address - Phone:484-456-8247
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-30
Last Update Date:2015-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)