Individual
BRENDA KIRK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2465 AMANN DR, BELLEVILLE, IL 62220-3463
(618) 236-5277
Mailing address
2465 AMANN DR, BELLEVILLE, IL 62220-3463
(618) 236-5277
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
146.009720
IL
235Z00000X
Speech-Language Pathologist
Primary
2536337
IL
Other
Enumeration date
12/02/2013
Last updated
12/02/2013
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