Individual
DONNA M VAN KIRK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
EDD
Contact information
Practice address
204 N EAST AVE, FAYETTEVILLE, AR 72701-5225
(479) 466-9609
(479) 431-4948
Mailing address
31 S KESTREL DR, FAYETTEVILLE, AR 72701-1322
(479) 466-0960
(479) 431-4948
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
8210P
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
116603719
—
AR
Enumeration date
06/28/2006
Last updated
11/27/2019
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