IndividualActive
Kevin Moyer-Wilkes, M.ED., NCC
NPI 1851639488 · Emotionally Disturbed Childrens' Residential Treatment Facility · Boylston, MA
Provider details
- NPI number
- 1851639488
- Entity type
- Individual
- Primary specialty
- Emotionally Disturbed Childrens' Residential Treatment FacilityResidential Treatment Facilities
- Credential
- M.ED., NCC
- Sex
- Male
- Sole proprietor
- Yes
- License
- 463166 (MA)
Practice location
1 Elmwood Pl
Boylston, MA 01505-2040
Phone: (508) 869-0197
Fax: (508) 869-0313
Mailing address
16 Saxon Rd
Worcester, MA 01602-1522
Registry dates
- Enumerated
- 2013-01-16
- Last updated
- 2013-01-16
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.