NPI Code Detail JSON Logo

1053873703 NPI number — LAURA KIRSCH PHD

NPI Number: 1053873703
Health Care Provider/Practitioner: LAURA KIRSCH PHD

Information about “1053873703” NPI (LAURA KIRSCH PHD) exists in 1053873703 in HTML format HTML  |  1053873703 in plain Text format TXT  |  1053873703 in PDF (Portable Document Format) PDF  |  1053873703 in an XML format XML  formats.

NPI Number : 1053873703 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1053873703",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "KIRSCH",
    "FirstName": "LAURA",
    "MiddleName": null,
    "NamePrefix": "DR.",
    "NameSuffix": null,
    "Credential": "PHD",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "91 CAMPUS DRIVE,",
    "SecondLineMailingAddress": "PMB 2608",
    "MailingAddressCityName": "MISSOULA",
    "MailingAddressStateName": "MT",
    "MailingAddressPostalCode": "59801",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "406-207-7870",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "1444 MANSFIELD AVE",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "MISSOULA",
    "PracticeLocationAddressStateName": "MT",
    "PracticeLocationAddressPostalCode": "59812-0001",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "406-207-7870",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "04/02/2019",
    "LastUpdateDate": "04/02/2019",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "103TC0700X",
        "TaxonomyName": "Clinical Psychologist",
        "LicenseNumber": "1267",
        "LicenseNumberStateCode": "MT",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

Copyright © 2007-2026 Data Labs Health. All rights reserved.