Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YP2500X | Professional Counselor | 79810 | TX |
Y | 103TS0200X | School Psychologist | 71967 | TX |
NPI | 1063183531 |
---|---|
Provider Name | Ariel Kirkland |
First Address | Lubbock, TX 79424-8763 |
Second Address | Lorenzo, TX 79343 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/09/2021 |
Last Update Date | 24/09/2021 |