Provider Demographics
NPI:1548453145
Name:KIRKER, KARA MARIE (PHD)
Entity type:Individual
Prefix:
First Name:KARA
Middle Name:MARIE
Last Name:KIRKER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:KARA
Other - Middle Name:KIRKER
Other - Last Name:GABRIELE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD
Mailing Address - Street 1:3 MEADOW RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:WESTERLY
Mailing Address - State:RI
Mailing Address - Zip Code:02891-4001
Mailing Address - Country:US
Mailing Address - Phone:401-965-5607
Mailing Address - Fax:401-783-7596
Practice Address - Street 1:24 SALT POND RD STE B4
Practice Address - Street 2:
Practice Address - City:WAKEFIELD
Practice Address - State:RI
Practice Address - Zip Code:02879-4320
Practice Address - Country:US
Practice Address - Phone:401-965-5607
Practice Address - Fax:401-783-7596
Is Sole Proprietor?:No
Enumeration Date:2007-08-27
Last Update Date:2018-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIPS01028103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical