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Individual

DR. ANGELA M KIRK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PHD, LSW, LICDC-CS

Contact information

Practice address
547 E 11TH AVE, COLUMBUS, OH 43211-2603
(614) 586-7969
(614) 291-0118
Mailing address
547 E 11TH AVE, COLUMBUS, OH 43211-2603
(614) 586-7969
(614) 291-0118

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
923328
OH
104100000X
Social Worker
S0006860
OH

Other

Enumeration date
03/08/2016
Last updated
03/08/2016
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