Individual
DR. BENJAMIN WILLIAM BIRKBY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSY.D.
Contact information
Practice address
6500 GLENRIDGE PARK PL, SUITE 3, LOUISVILLE, KY 40222-3450
(502) 417-5217
Mailing address
6500 GLENRIDGE PARK PL, SUITE 3, LOUISVILLE, KY 40222-3450
(502) 417-5217
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
1225
KY
103TC2200X
Clinical Child & Adolescent Psychologist
1225
KY
Other
Enumeration date
11/19/2012
Last updated
11/19/2012
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