| Doctor Name: | MINA KIRKOVA |
| NPI Number: | 1114118387 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MA, MSW, LCSW-C |
| License Number: | L4478 |
| Business Practice Address: | 9 Schilling Rd Suite 200 Hunt Valley, MD - 210311191 |
| Business Phone Number: | 4109887247 |
| Business Fax Number: | 4432759585 |
| Mailing Address: | 4 Shelbys Path, Apt. L SPARKS |
| State: | MD |
| Postal Code: | 211529239 |
| Phone Number: | 4109887247 |
| Fax Number: | 4432759585 |
| NPI Enumeration Date: | 08/05/2007 |
| NPI Last Update Date: | 04/20/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | L4478 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | OR |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |