Individual
JEREMY KIRK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CSAC
Contact information
Practice address
1 N 5TH ST STE 400, RICHMOND, VA 23219-2231
(804) 243-9107
Mailing address
1 N 5TH ST STE 400, RICHMOND, VA 23219-2231
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
0710103768
VA
Other
Enumeration date
12/18/2024
Last updated
12/18/2024
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