Most Relevant Information
Provider Data
| NPI Number: | 1003679234 |
| Provider Name: | KIRBY KACZOR LPCC |
| Entity Type: | Individual |
| Taxonomy Code: | 101Y00000X |
| Specialty: | Counselor |
| License Number: | 4263 |
Most Important Dates
| Enumeration Date: | 01/31/2024 |
| Last Updated: | 01/31/2024 |
Provider Practice Location
2025 4TH ST STE 100
WHITE BEAR LAKE
MN
551102875
Practice Location Phone/Fax
| Phone: | 6512124920 |
| Fax: |
Provider Mailing Location
2025 4TH ST STE 100
WHITE BEAR LAKE
MN
551102875
Provider Mailing Phone/Fax
| Phone: | 6512124920 |
| Fax: |