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Individual
DR. MARIO DEWAYNE KIRK
Active
Individual
DR. MARIO DEWAYNE KIRK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPC
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
3912
OK
101YM0800X
Mental Health Counselor
Primary
PSB94023546
CA
101YP2500X
Professional Counselor
3912
OK
101YS0200X
School Counselor
3912
OK
Other
Enumeration date
10/29/2007
Last updated
01/04/2019
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