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Organization

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Organization subpart
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Provider details

NPI number
Authorized official
DR. ANDREA KIRBY PSYD (CLINICAL PSYCHOLOGIST)
(817) 381-5259
Entity
Organization

Contact information

Practice address
1340 N WHITE CHAPEL BLVD STE 130, SOUTHLAKE, TX 76092-4327
(817) 381-5259
Mailing address
1340 N WHITE CHAPEL BLVD STE 130, SOUTHLAKE, TX 76092-4327
(817) 381-5259

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)

Other

Enumeration date
01/03/2024
Last updated
01/16/2024
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