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General NPI Number Information
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NPI Number | 1619421229
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Entity Type | Individual
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Provider Name | MRS. LINDA KIRKBRIDE
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Gender | Female
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Dates
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Enumeration Date | 08/11/2016
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Last Update Date | 08/11/2016
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Provider Practice Location Address
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Address Line | 2951 MAPLE AVE
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City | ZANESVILLE
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State | OH
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Zip | 43701-1406
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Country | US
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Telephone | 740-454-5927
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Fax |
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Provider Business Mailing Address
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Address Line | 5675 SUGAR GROVE RD
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City | BLUE ROCK
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State | OH
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Zip | 43720-9542
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Country | US
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Telephone | 740-674-4383
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number | E0700924
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 965611
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License Number State | OH
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Taxonomy #3
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN187095
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License Number State | OH
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