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Individual

LARRY KIRKLAND

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
3051 SINCLAIR LANE, BALTIMORE, MD 21213
(410) 558-4888
Mailing address
735 E LAKE AVE, BALTIMORE, MD 21212-3105

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
AC0319
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
521358241
MD
Enumeration date
09/01/2016
Last updated
09/01/2016
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