Diane C.Kirk, Psy.D, PLLC
Organization Active NPI Clinical Psychologist · Tulsa, OK
NPI 1992259535 · NPPES record last updated Aug 11, 2016
Key facts
- NPI
- 1992259535
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Clinical Psychologist 103TC0700X
- License
- 1234 (OK)
- Legal business name
- DIANE C.KIRK, PSY.D, PLLC
- Practice address
- 3010 S Harvard Ave
Suite 110
Tulsa, OK 74114-6124 - Phone
- (302) 545-5353
- NPI assigned
- Aug 11, 2016
- Organization subpart
- No
Authorized official
- Name
- Dr. Diane C Kirk, PSY.D.
- Title
- Clinical Psychologist
- Phone
- (302) 545-5353
Practitioners 1
-
Diane Constance Kirk, PSY.D.
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist |
103TC0700X | 1234 | OK | Yes |
Addresses
Primary practice location
3010 S Harvard Ave
Suite 110
Tulsa, OK 74114-6124
Mailing address
1616 E 32ND PL
Tulsa, OK 74105-2117
Phone (302) 545-5353
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200594670A | Medicaid | OK |
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All providers in Tulsa, OK · Clinical Psychologist in Oklahoma
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 11, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.