Individual
JACQUELINE KIRBY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5212 FOX HUNT DR APT A, GREENSBORO, NC 27407-7118
(336) 541-4545
Mailing address
1509 GUINNESS DR, MC LEANSVILLE, NC 27301-9512
(336) 541-4545
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
—
Other
Enumeration date
06/02/2018
Last updated
06/02/2018
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