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General NPI Number Information
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NPI Number | 1881134807
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Entity Type | Individual
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Provider Name | CARMEN KIRKPATRICK LSW
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Gender | Female
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Dates
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Enumeration Date | 02/24/2017
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Last Update Date | 02/28/2017
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Provider Practice Location Address
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Address Line | 1 ELIZABETH PL
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City | DAYTON
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State | OH
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Zip | 45417-3445
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Country | US
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Telephone | 937-301-5549
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Fax |
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Provider Business Mailing Address
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Address Line | 2901 TAOS DR
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City | MIAMISBURG
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State | OH
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Zip | 45342-4502
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Country | US
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Telephone | 937-231-8246
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | S.0500084
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License Number State | OH
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