Individual
KEVIN P KIRLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.S.
Contact information
Practice address
10535 165TH ST W, LAKEVILLE, MN 55044-5729
(952) 435-0022
Mailing address
10535 165TH STREET W., LAKEVILLE, MN 55044
(952) 435-0022
Taxonomy
Speciality
Code
Description
License number
State
103TB0200X
Cognitive & Behavioral Psychologist
Primary
LP1249
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10N14KI
BLUE CROSS BLUE SHIELD
MN
01
—
138154
U CARE
MN
01
—
30433-01
PREFERRED ONE
MN
01
—
62-50536
MEDICA-UBH
MN
01
—
HP50743
HEALTH PARTNERS
MN
Enumeration date
12/05/2006
Last updated
07/08/2007
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