Individual
KIMBERLY KIRK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PC-CR, LCDC III
Contact information
Practice address
2796 MACK RD, FAIRFIELD, OH 45014-5129
(513) 861-1100
Mailing address
2796 MACK RD, FAIRFIELD, OH 45014-5129
(513) 861-1100
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
LCDC.141082-3
OH
101YP2500X
Professional Counselor
Primary
C.0500898-CR
OH
Other
Enumeration date
08/15/2014
Last updated
08/15/2014
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