Individual
DOUGLAS ALLEN KIRK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
306 N BROOKS ST, MADISON, WI 53715-1002
(608) 280-7195
(608) 256-0743
Mailing address
1602 WICKLOW WAY, MADISON, WI 53711-3665
(608) 280-7195
(608) 256-0743
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
7093-123
WI
Other
Enumeration date
08/17/2006
Last updated
07/08/2007
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