| Doctor Name: | DR. KATHLEEN MARY IRWIN |
| NPI Number: | 1063635217 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PSY.D. |
| License Number: | |
| Business Practice Address: | 722 15th St. Bemidji, MN - 56601 |
| Business Phone Number: | 2187513280 |
| Business Fax Number: | 2187513298 |
| Mailing Address: | P.o. Box 640, Unit B-205 BEMIDJI |
| State: | MN |
| Postal Code: | 566190640 |
| Phone Number: | 2187513280 |
| Fax Number: | 2187513298 |
| NPI Enumeration Date: | 04/10/2007 |
| NPI Last Update Date: | 06/13/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |