Individual provider · Type 1 NPI
Courtney Dyan Kirk
Developmental Therapist · Decatur, IL
Practice location
4815 N Martin Luther King Jr Dr, Apt 112
Decatur, IL 62526-6127
Mailing address
4815 N Martin Luther King Jr. Dr., Apt 112
Decatur, IL 62526
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Developmental Therapist Primary | 222Q00000X | None listed |
Developmental Therapist: A Developmental Therapist is a person qualified by completion of an approved program in Developmental Therapy and where applicable credentialed by the state and practicing within the scope of the credential, or credentialed by completion of education experiences as approved by the state and practicing within the scope of that credential or, where state credentialing does not exist, certified by the Board of the Deve…
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About NPI 1295063881
Courtney Dyan Kirk's National Provider Identifier is 1295063881, issued on Nov 20, 2009. The primary taxonomy on file is Developmental Therapist (222Q00000X), and the practice location is in Decatur, IL. The record was last updated on Nov 20, 2009.