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General NPI Number Information
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NPI Number | 1447899737
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Entity Type | Individual
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Provider Name | JACQUELINE S KIRKBRIDE LISW
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Gender | Female
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Dates
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Enumeration Date | 01/03/2020
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Last Update Date | 01/02/2026
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Provider Practice Location Address
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Address Line | 4035 NORTHPOINTE DR UNIT B
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City | ZANESVILLE
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State | OH
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Zip | 43701-1738
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Country | US
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Telephone | 740-487-1768
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Fax | 740-870-0086
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Provider Business Mailing Address
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Address Line | 4583 STRATTFORD DR
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City | ZANESVILLE
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State | OH
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Zip | 43701-7060
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Country | US
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Telephone | 740-704-8423
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | S.1904623
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License Number State | OH
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