Provider Demographics
NPI:1679944250
Name:KIRK, EMILY (PHD)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:KIRK
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6544 MURRAY LN
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-5515
Mailing Address - Country:US
Mailing Address - Phone:615-507-3180
Mailing Address - Fax:615-507-3179
Practice Address - Street 1:6544 MURRAY LN
Practice Address - Street 2:
Practice Address - City:BRENTWOOD
Practice Address - State:TN
Practice Address - Zip Code:37027-5515
Practice Address - Country:US
Practice Address - Phone:615-507-3180
Practice Address - Fax:615-507-3179
Is Sole Proprietor?:No
Enumeration Date:2015-10-08
Last Update Date:2015-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNP0000003101103TH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TH0100XBehavioral Health & Social Service ProvidersPsychologistHealth Service