NPI | 1255666400 |
---|---|
Former Name | MALINDA J KIRK |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: PA CW016782) |
Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: PA SW127316) |
101YM0800X Counselor Mental Health (Licence: PA SW127316) | |
Enumeration Date | 2009-10-06 |
Last Update Date | 2021-04-15 |