Individual
KRISSA KIRBY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D
Contact information
Practice address
1870 LEONARD ST NE, GRAND RAPIDS, MI 49505-5650
(616) 956-9619
Mailing address
300 68TH ST SE, GRAND RAPIDS, MI 49548-6927
(616) 455-5000
(616) 455-5000
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
390
MT
103T00000X
Psychologist
PY6399
FL
103TC0700X
Clinical Psychologist
Primary
6301016704
MI
Other
Enumeration date
09/12/2005
Last updated
09/18/2023
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