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General NPI Number Information
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NPI Number | 1851801344
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Entity Type | Individual
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Provider Name | KIRBY BLAIR WOOD LPC
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Gender | Female
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Dates
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Enumeration Date | 10/10/2017
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Last Update Date | 06/11/2021
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Provider Practice Location Address
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Address Line | 4601 50TH ST STE 108A
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City | LUBBOCK
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State | TX
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Zip | 79414-3513
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Country | US
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Telephone | 806-305-2012
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 65737
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City | LUBBOCK
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State | TX
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Zip | 79464-5681
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Country | US
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Telephone | 806-305-2012
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 74244
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 74244
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License Number State | TX
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