Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC1900X | Counseling Psychologist | P0000001087 | TN |
NPI | 1053352880 |
---|---|
Provider Name | Kristie L Kirby |
First Address | Gallatin, TN 37066-0059 |
Second Address | Brentwood, TN 37027-6709 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/06/2006 |
Last Update Date | 08/07/2007 |