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General NPI Number Information
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NPI Number | 1477023547
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Entity Type | Individual
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Provider Name | ALYSSA KIRBY MA
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Gender | Female
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Dates
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Enumeration Date | 11/30/2018
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Last Update Date | 01/06/2026
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Provider Practice Location Address
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Address Line | 712 ESSINGTON RD
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City | JOLIET
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State | IL
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Zip | 60435-4912
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Country | US
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Telephone | 872-318-4884
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Fax |
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Provider Business Mailing Address
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Address Line | 712 ESSINGTON RD
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City | JOLIET
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State | IL
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Zip | 60435-4912
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Country | US
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Telephone | 872-318-4884
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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 | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 1-26-86902
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License Number State | IL
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