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General NPI Number Information
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NPI Number | 1639357668
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Entity Type | Individual
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Provider Name | JOHNNY L. KIRBY JR. LPA
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Gender | Male
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Dates
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Enumeration Date | 01/31/2008
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Last Update Date | 09/20/2012
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Provider Practice Location Address
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Address Line | 211 S NC 127 HWY SUITE 130
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City | HICKORY
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State | NC
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Zip | 28602-3541
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Country | US
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Telephone | 828-315-1368
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Fax | 828-270-7868
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Provider Business Mailing Address
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Address Line | 75 BROWNING DR
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City | TAYLORSVILLE
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State | NC
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Zip | 28681-6642
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Country | US
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Telephone | 828-315-1368
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Fax | 828-270-7868
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 2364
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 103TS0200X
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Taxonomy Name | School Psychologist
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License Number | 2364
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License Number State | NC
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