Provider Demographics
NPI:1730536541
Name:KIRKPATRICK, WILLIAM DONALD
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:DONALD
Last Name:KIRKPATRICK
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:921 E 14TH ST
Mailing Address - Street 2:
Mailing Address - City:ADA
Mailing Address - State:OK
Mailing Address - Zip Code:74820-6817
Mailing Address - Country:US
Mailing Address - Phone:661-476-6865
Mailing Address - Fax:
Practice Address - Street 1:921 E 14TH ST
Practice Address - Street 2:
Practice Address - City:ADA
Practice Address - State:OK
Practice Address - Zip Code:74820-6817
Practice Address - Country:US
Practice Address - Phone:661-476-6865
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-22
Last Update Date:2016-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst