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General NPI Number Information
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NPI Number | 1548990781
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Entity Type | Organization
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Legal Business Name | KIRKINDOFF CORNER COUNSELING
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Dates
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Enumeration Date | 06/11/2022
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Last Update Date | 10/24/2022
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Provider Practice Location Address
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Address Line | 1601 REDBUD ST
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City | NACOGDOCHES
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State | TX
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Zip | 75965-2947
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Country | US
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Telephone | 870-953-0183
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 2134
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City | HENDERSON
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State | TX
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Zip | 75653-2134
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Country | US
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Telephone | 870-953-0183
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Fax |
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Authorized Official
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Title or Position | LICENSED PROFESSIONAL COUNSELOR
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Name | MRS. ADRIANA DANIELLE KIRKINDOFF
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Credential | LPC
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Telephone | 972-652-0095
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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