Organization
DONNA M VAN KIRK EDD PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DONNA M VAN KIRK EDD (PSYCHOLOGIST)
(479) 466-9609
Entity
Organization
Contact information
Practice address
204 N EAST AVE, FAYETTEVILLE, AR 72701-5225
(479) 466-9609
(479) 442-5587
Mailing address
31 S KESTREL DR, FAYETTEVILLE, AR 72701-1322
(479) 466-9609
(479) 442-5587
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
82-P10
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
116603719
—
AR
Enumeration date
01/07/2016
Last updated
01/07/2016
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