Individual
DR. DIANE CONSTANCE KIRK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
3010 S HARVARD AVENUE, SUITE 110, TULSA, OK 74114-6124
(302) 948-6030
(918) 749-1841
Mailing address
1616 E 32ND PL, TULSA, OK 74105-2117
(918) 992-7006
(918) 749-1841
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
1234
OK
103TC0700X
Clinical Psychologist
B1-0000315
DE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200594670A
—
OK
Enumeration date
02/04/2011
Last updated
10/28/2016
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