Provider Demographics
NPI:1780892737
Name:KILBANE, JANET LEE (MED, CRC)
Entity type:Individual
Prefix:MS
First Name:JANET
Middle Name:LEE
Last Name:KILBANE
Suffix:
Gender:F
Credentials:MED, CRC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2473 DOGWOOD PL
Mailing Address - Street 2:
Mailing Address - City:BLACKLICK
Mailing Address - State:OH
Mailing Address - Zip Code:43004-9728
Mailing Address - Country:US
Mailing Address - Phone:671-493-9461
Mailing Address - Fax:614-939-4619
Practice Address - Street 1:2473 DOGWOOD PL
Practice Address - Street 2:
Practice Address - City:BLACKLICK
Practice Address - State:OH
Practice Address - Zip Code:43004-9728
Practice Address - Country:US
Practice Address - Phone:671-493-9461
Practice Address - Fax:614-939-4619
Is Sole Proprietor?:No
Enumeration Date:2007-05-21
Last Update Date:2007-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH027410101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor