Most Relevant Information
Provider Data
| NPI Number: | 1003317637 |
| Provider Name: | THERESE KIRKPATRICK LMSW |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: | 010557591 |
Most Important Dates
| Enumeration Date: | 02/28/2018 |
| Last Updated: | 04/05/2023 |
Provider Practice Location
1304 BERTRAND DR STE E3
LAFAYETTE
LA
705069105
Practice Location Phone/Fax
| Phone: | 3379621987 |
| Fax: |
Provider Mailing Location
1304 BERTRAND DR STE E3
LAFAYETTE
LA
705069105
Provider Mailing Phone/Fax
| Phone: | 3379621987 |
| Fax: |