Basic Information
| Provider Information | |||||||||
| NPI: | 1346654241 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | KIRCHOFF | ||||||||
| FirstName: | AUBREY | ||||||||
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| Credential: | MA, MSN, LPC, APRN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3501 MILLS AVE | ||||||||
| Address2: | |||||||||
| City: | AUSTIN | ||||||||
| State: | TX | ||||||||
| PostalCode: | 787316309 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 411 CHANDLER ST | ||||||||
| Address2: | |||||||||
| City: | WORCESTER | ||||||||
| State: | MA | ||||||||
| PostalCode: | 016023339 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7742437486 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/18/2014 | ||||||||
| LastUpdateDate: | 09/10/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | 78132 | TX | N | Behavioral Health & Social Service Providers | Counselor | Mental Health | 363LP0808X | AP142443 | TX | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Psych/Mental Health |
No ID Information.