Provider Demographics
NPI:1467832865
Name:KIRKEBY, KIMBERLEY
Entity Type:Individual
Prefix:
First Name:KIMBERLEY
Middle Name:
Last Name:KIRKEBY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 W 1ST ST
Mailing Address - Street 2:STE 120
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89503-5675
Mailing Address - Country:US
Mailing Address - Phone:775-624-8200
Mailing Address - Fax:775-624-8222
Practice Address - Street 1:900 W 1ST ST
Practice Address - Street 2:STE 120
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89503-5675
Practice Address - Country:US
Practice Address - Phone:775-624-8200
Practice Address - Fax:775-624-8222
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-02
Last Update Date:2015-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health