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General NPI Number Information
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NPI Number | 1407174428
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Entity Type | Individual
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Provider Name | ANGELA GAYL KIRKLAND M.A.
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Gender | Female
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Dates
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Enumeration Date | 05/14/2010
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Last Update Date | 01/06/2020
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Provider Practice Location Address
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Address Line | 1092 DUVAL STREET SUITE 230
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City | LEXINGTON
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State | KY
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Zip | 40515-8906
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Country | US
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Telephone | 859-523-7383
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Fax | 859-523-7384
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Provider Business Mailing Address
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Address Line | 2028 PARASOL DRIVE
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City | LEXINGTON
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State | KY
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Zip | 40513-1077
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 134
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License Number State | KY
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