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Individual

JONATHAN KIRBY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LMFT

Contact information

Practice address
1900 SILVER LAKE RD NW, SUITE 110, NEW BRIGHTON, MN 55112-1786
(651) 628-9566
Mailing address
1242 BERWICK LN, MAHTOMEDI, MN 55115-2839

Taxonomy

Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
2970
MN

Other

Enumeration date
08/20/2014
Last updated
08/20/2014
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