Healthcare Provider Details

I. General information

NPI: 1548453145
Provider Name (Legal Business Name): KARA MARIE KIRKER PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KARA KIRKER GABRIELE PHD

II. Dates (important events)

Enumeration Date: 08/27/2007
Last Update Date: 10/05/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24 SALT POND RD STE B4
WAKEFIELD RI
02879-4320
US

IV. Provider business mailing address

3 MEADOW RIDGE RD
WESTERLY RI
02891-4001
US

V. Phone/Fax

Practice location:
  • Phone: 401-965-5607
  • Fax: 401-783-7596
Mailing address:
  • Phone: 401-965-5607
  • Fax: 401-783-7596

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPS01028
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: