Doctor Name: | MR. JEFFREY BRUCE KIRBY |
NPI Number: | 1194976027 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MA LPC |
License Number: | 6401006208 |
Business Practice Address: | 320 E Warwick Dr Alma, MI - 488011014 |
Business Phone Number: | 9894634971 |
Business Fax Number: | 9894636515 |
Mailing Address: | Po Box 69, ALMA |
State: | MI |
Postal Code: | 488010069 |
Phone Number: | 9894634971 |
Fax Number: | 9894665470 |
NPI Enumeration Date: | 10/09/2008 |
NPI Last Update Date: | 10/09/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | 6401006208 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MI |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |