Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC1900X | Counseling Psychologist |
NPI | 1104488972 |
---|---|
Provider Name | Dr. Brett Kirkpatrick |
First Address | Baltimore, MD 21212-1934 |
Second Address | Ellicott City, MD 21042-7877 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/07/2019 |
Last Update Date | 29/09/2021 |