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Individual

MR. KIRK JOHN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
ED.D.

Contact information

Practice address
99 S PENNSYLVANIA AVE, UNIONTOWN, PA 15401-4236
(724) 430-0555
(724) 430-0966
Mailing address
99 S PENNSYLVANIA AVE, UNIONTOWN, PA 15401-4236
(724) 430-0555
(724) 430-0966

Taxonomy

Speciality
Code
Description
License number
State
103TB0200X
Cognitive & Behavioral Psychologist
Primary
PS003300L
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0017125050001
PA
Enumeration date
03/12/2010
Last updated
03/12/2010
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